Malaria Transmission Dynamics in a High-Transmission Setting of Western Kenya and the Inadequate Treatment Response to Artemether-Lumefantrine in an Asymptomatic Population
| Autor: | Ben Andagalu, Oliver J Watson, Irene Onyango, Benjamin Opot, Raphael Okoth, Gladys Chemwor, Peter Sifuna, Dennis Juma, Agnes Cheruiyot, Redemptah Yeda, Charles Okudo, Jackline Wafubwa, Santos Yalwala, David Abuom, Bernhards Ogutu, Jessica Cowden, Hoseah M Akala, Edwin Kamau |
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| Rok vydání: | 2022 |
| Předmět: | |
| Zdroj: | Clinical Infectious Diseases. 76:704-712 |
| ISSN: | 1537-6591 1058-4838 |
| DOI: | 10.1093/cid/ciac527 |
| Popis: | Background Assessing the infectious reservoir is critical in malaria control and elimination strategies. We conducted a longitudinal epidemiological study in a high-malaria-burden region in Kenya to characterize transmission in an asymptomatic population. Methods 488 study participants encompassing all ages in 120 households within 30 clusters were followed for 1 year with monthly sampling. Malaria was diagnosed by microscopy and molecular methods. Transmission potential in gametocytemic participants was assessed using direct skin and/or membrane mosquito feeding assays, then treated with artemether-lumefantrine. Study variables were assessed using mixed-effects generalized linear models. Results Asexual and sexual parasite data were collected from 3792 participant visits, with 903 linked with feeding assays. Univariate analysis revealed that the 6–11-year-old age group was at higher risk of harboring asexual and sexual infections than those Conclusions Individuals with asymptomatic infection sustain the transmission cycle, with the 6–11-year age group serving as an important reservoir. The high rates of artemether-lumefantrine treatment failures suggest surveillance programs using molecular methods need to be expanded for accurate monitoring and evaluation of treatment outcomes. |
| Databáze: | OpenAIRE |
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