Differential impact of malaria control interventions on P. falciparum and P. vivax infections in young Papua New Guinean children
Abstract Introduction As malaria transmission declines, understanding the differential impact of intensified control on Plasmodium falciparum relative to Plasmodium vivax and identifying key drivers of ongoing transmission is essential to guide future interventions. Methods Three longitudinal child...
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BMC
2019-12-01
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| Series: | BMC Medicine |
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| Online Access: | https://doi.org/10.1186/s12916-019-1456-9 |
| _version_ | 1818623395708796928 |
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| author | Maria Ome-Kaius Johanna Helena Kattenberg Sophie Zaloumis Matthew Siba Benson Kiniboro Shadrach Jally Zahra Razook Daisy Mantila Desmond Sui Jason Ginny Anna Rosanas-Urgell Stephan Karl Thomas Obadia Alyssa Barry Stephen J. Rogerson Moses Laman Daniel Tisch Ingrid Felger James W. Kazura Ivo Mueller Leanne J. Robinson |
| author_facet | Maria Ome-Kaius Johanna Helena Kattenberg Sophie Zaloumis Matthew Siba Benson Kiniboro Shadrach Jally Zahra Razook Daisy Mantila Desmond Sui Jason Ginny Anna Rosanas-Urgell Stephan Karl Thomas Obadia Alyssa Barry Stephen J. Rogerson Moses Laman Daniel Tisch Ingrid Felger James W. Kazura Ivo Mueller Leanne J. Robinson |
| author_sort | Maria Ome-Kaius |
| collection | DOAJ |
| description | Abstract Introduction As malaria transmission declines, understanding the differential impact of intensified control on Plasmodium falciparum relative to Plasmodium vivax and identifying key drivers of ongoing transmission is essential to guide future interventions. Methods Three longitudinal child cohorts were conducted in Papua New Guinea before (2006/2007), during (2008) and after scale-up of control interventions (2013). In each cohort, children aged 1–5 years were actively monitored for infection and illness. Incidence of malaria episodes, molecular force of blood-stage infections (molFOB) and population-averaged prevalence of infections were compared across the cohorts to investigate the impact of intensified control in young children and the key risk factors for malaria infection and illness in 2013. Results Between 2006 and 2008, P. falciparum infection prevalence, molFOB, and clinical malaria episodes reduced by 47%, 59% and 69%, respectively, and a further 49%, 29% and 75% from 2008 to 2013 (prevalence 41.6% to 22.1% to 11.2%; molFOB: 3.4 to 1.4 to 1.0 clones/child/year; clinical episodes incidence rate (IR) 2.6 to 0.8 to IR 0.2 episodes/child/year). P. vivax clinical episodes declined at rates comparable to P. falciparum between 2006, 2008 and 2013 (IR 2.5 to 1.1 to 0.2), while P. vivax molFOB (2006, 9.8; 2008, 12.1) and prevalence (2006, 59.6%; 2008, 65.0%) remained high in 2008. However, in 2013, P. vivax molFOB (1.2) and prevalence (19.7%) had also substantially declined. In 2013, 89% of P. falciparum and 93% of P. vivax infections were asymptomatic, 62% and 47%, respectively, were sub-microscopic. Area of residence was the major determinant of malaria infection and illness. Conclusion Intensified vector control and routine case management had a differential impact on rates of P. falciparum and P. vivax infections but not clinical malaria episodes in young children. This suggests comparable reductions in new mosquito-derived infections but a delayed impact on P. vivax relapsing infections due to a previously acquired reservoir of hypnozoites. This demonstrates the need to strengthen implementation of P. vivax radical cure to maximise impact of control in co-endemic areas. The high heterogeneity of malaria in 2013 highlights the importance of surveillance and targeted interventions to accelerate towards elimination. |
| first_indexed | 2024-12-16T18:40:23Z |
| format | Article |
| id | doaj.art-1d960c0581e9451eb49696bc17db4088 |
| institution | Directory Open Access Journal |
| issn | 1741-7015 |
| language | English |
| last_indexed | 2024-12-16T18:40:23Z |
| publishDate | 2019-12-01 |
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| spelling | doaj.art-1d960c0581e9451eb49696bc17db40882022-12-21T22:21:04ZengBMCBMC Medicine1741-70152019-12-0117111310.1186/s12916-019-1456-9Differential impact of malaria control interventions on P. falciparum and P. vivax infections in young Papua New Guinean childrenMaria Ome-Kaius0Johanna Helena Kattenberg1Sophie Zaloumis2Matthew Siba3Benson Kiniboro4Shadrach Jally5Zahra Razook6Daisy Mantila7Desmond Sui8Jason Ginny9Anna Rosanas-Urgell10Stephan Karl11Thomas Obadia12Alyssa Barry13Stephen J. Rogerson14Moses Laman15Daniel Tisch16Ingrid Felger17James W. Kazura18Ivo Mueller19Leanne J. Robinson20Papua New Guinea Institute of Medical ResearchPapua New Guinea Institute of Medical ResearchDepartment of Medical Biology, University of MelbournePapua New Guinea Institute of Medical ResearchPapua New Guinea Institute of Medical ResearchPapua New Guinea Institute of Medical ResearchWalter and Eliza Hall Institute of Medical ResearchPapua New Guinea Institute of Medical ResearchPapua New Guinea Institute of Medical ResearchPapua New Guinea Institute of Medical ResearchInstitute of Tropical MedicinePapua New Guinea Institute of Medical ResearchInstitut PasteurWalter and Eliza Hall Institute of Medical ResearchDepartment of Medical Biology, University of MelbournePapua New Guinea Institute of Medical ResearchCase Western Reserve UniversitySwiss Tropical and Public Health InstituteCase Western Reserve UniversityWalter and Eliza Hall Institute of Medical ResearchPapua New Guinea Institute of Medical ResearchAbstract Introduction As malaria transmission declines, understanding the differential impact of intensified control on Plasmodium falciparum relative to Plasmodium vivax and identifying key drivers of ongoing transmission is essential to guide future interventions. Methods Three longitudinal child cohorts were conducted in Papua New Guinea before (2006/2007), during (2008) and after scale-up of control interventions (2013). In each cohort, children aged 1–5 years were actively monitored for infection and illness. Incidence of malaria episodes, molecular force of blood-stage infections (molFOB) and population-averaged prevalence of infections were compared across the cohorts to investigate the impact of intensified control in young children and the key risk factors for malaria infection and illness in 2013. Results Between 2006 and 2008, P. falciparum infection prevalence, molFOB, and clinical malaria episodes reduced by 47%, 59% and 69%, respectively, and a further 49%, 29% and 75% from 2008 to 2013 (prevalence 41.6% to 22.1% to 11.2%; molFOB: 3.4 to 1.4 to 1.0 clones/child/year; clinical episodes incidence rate (IR) 2.6 to 0.8 to IR 0.2 episodes/child/year). P. vivax clinical episodes declined at rates comparable to P. falciparum between 2006, 2008 and 2013 (IR 2.5 to 1.1 to 0.2), while P. vivax molFOB (2006, 9.8; 2008, 12.1) and prevalence (2006, 59.6%; 2008, 65.0%) remained high in 2008. However, in 2013, P. vivax molFOB (1.2) and prevalence (19.7%) had also substantially declined. In 2013, 89% of P. falciparum and 93% of P. vivax infections were asymptomatic, 62% and 47%, respectively, were sub-microscopic. Area of residence was the major determinant of malaria infection and illness. Conclusion Intensified vector control and routine case management had a differential impact on rates of P. falciparum and P. vivax infections but not clinical malaria episodes in young children. This suggests comparable reductions in new mosquito-derived infections but a delayed impact on P. vivax relapsing infections due to a previously acquired reservoir of hypnozoites. This demonstrates the need to strengthen implementation of P. vivax radical cure to maximise impact of control in co-endemic areas. The high heterogeneity of malaria in 2013 highlights the importance of surveillance and targeted interventions to accelerate towards elimination.https://doi.org/10.1186/s12916-019-1456-9P. falciparumP. vivaxPapua New GuineaEpidemiologyMalaria controlIncidence |
| spellingShingle | Maria Ome-Kaius Johanna Helena Kattenberg Sophie Zaloumis Matthew Siba Benson Kiniboro Shadrach Jally Zahra Razook Daisy Mantila Desmond Sui Jason Ginny Anna Rosanas-Urgell Stephan Karl Thomas Obadia Alyssa Barry Stephen J. Rogerson Moses Laman Daniel Tisch Ingrid Felger James W. Kazura Ivo Mueller Leanne J. Robinson Differential impact of malaria control interventions on P. falciparum and P. vivax infections in young Papua New Guinean children BMC Medicine P. falciparum P. vivax Papua New Guinea Epidemiology Malaria control Incidence |
| title | Differential impact of malaria control interventions on P. falciparum and P. vivax infections in young Papua New Guinean children |
| title_full | Differential impact of malaria control interventions on P. falciparum and P. vivax infections in young Papua New Guinean children |
| title_fullStr | Differential impact of malaria control interventions on P. falciparum and P. vivax infections in young Papua New Guinean children |
| title_full_unstemmed | Differential impact of malaria control interventions on P. falciparum and P. vivax infections in young Papua New Guinean children |
| title_short | Differential impact of malaria control interventions on P. falciparum and P. vivax infections in young Papua New Guinean children |
| title_sort | differential impact of malaria control interventions on p falciparum and p vivax infections in young papua new guinean children |
| topic | P. falciparum P. vivax Papua New Guinea Epidemiology Malaria control Incidence |
| url | https://doi.org/10.1186/s12916-019-1456-9 |
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