Gametocyte dynamics and the role of drugs in reducing the transmission potential of Plasmodium vivax.
BACKGROUND: Designing interventions that will reduce transmission of vivax malaria requires knowledge of Plasmodium vivax gametocyte dynamics. METHODS: We analyzed data from a randomized controlled trial in northwestern Thailand and 2 trials in Papua, Indonesia, to identify and compare risk factors...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
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Oxford University Press
2013
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| _version_ | 1797092023658872832 |
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| author | Douglas, N Simpson, J Phyo, A Siswantoro, H Hasugian, A Kenangalem, E Poespoprodjo, JR Singhasivanon, P Anstey, N White, N Tjitra, E Nosten, F Price, R |
| author_facet | Douglas, N Simpson, J Phyo, A Siswantoro, H Hasugian, A Kenangalem, E Poespoprodjo, JR Singhasivanon, P Anstey, N White, N Tjitra, E Nosten, F Price, R |
| author_sort | Douglas, N |
| collection | OXFORD |
| description | BACKGROUND: Designing interventions that will reduce transmission of vivax malaria requires knowledge of Plasmodium vivax gametocyte dynamics. METHODS: We analyzed data from a randomized controlled trial in northwestern Thailand and 2 trials in Papua, Indonesia, to identify and compare risk factors for vivax gametocytemia at enrollment and following treatment. RESULTS: A total of 492 patients with P. vivax infections from Thailand and 476 patients (162 with concurrent falciparum parasitemia) from Indonesia were evaluable. Also, 84.3% (415/492) and 66.6% (209/314) of patients with monoinfection were gametocytemic at enrollment, respectively. The ratio of gametocytemia to asexual parasitemia did not differ between acute and recurrent infections (P = .48 in Thailand, P = .08 in Indonesia). High asexual parasitemia was associated with an increased risk of gametocytemia during follow-up in both locations. In Thailand, the cumulative incidence of gametocytemia between day 7 and day 42 following dihydroartemisinin + piperaquine (DHA + PIP) was 6.92% vs 29.1% following chloroquine (P < .001). In Indonesia, the incidence of gametocytemia was 33.6% following artesunate + amodiaquine (AS + AQ), 7.42% following artemether + lumefantrine, and 6.80% following DHA + PIP (P < .001 for DHA + PIP vs AS + AQ). CONCLUSIONS: P. vivax gametocyte carriage mirrors asexual-stage infection. Prevention of relapses, particularly in those with high asexual parasitemia, is likely the most important strategy for interrupting P. vivax transmission. |
| first_indexed | 2024-03-07T03:40:24Z |
| format | Journal article |
| id | oxford-uuid:bdaf8196-0ece-4300-986c-db1e03ea5f4c |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T03:40:24Z |
| publishDate | 2013 |
| publisher | Oxford University Press |
| record_format | dspace |
| spelling | oxford-uuid:bdaf8196-0ece-4300-986c-db1e03ea5f4c2022-03-27T05:33:49ZGametocyte dynamics and the role of drugs in reducing the transmission potential of Plasmodium vivax.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:bdaf8196-0ece-4300-986c-db1e03ea5f4cEnglishSymplectic Elements at OxfordOxford University Press2013Douglas, NSimpson, JPhyo, ASiswantoro, HHasugian, AKenangalem, EPoespoprodjo, JRSinghasivanon, PAnstey, NWhite, NTjitra, ENosten, FPrice, RBACKGROUND: Designing interventions that will reduce transmission of vivax malaria requires knowledge of Plasmodium vivax gametocyte dynamics. METHODS: We analyzed data from a randomized controlled trial in northwestern Thailand and 2 trials in Papua, Indonesia, to identify and compare risk factors for vivax gametocytemia at enrollment and following treatment. RESULTS: A total of 492 patients with P. vivax infections from Thailand and 476 patients (162 with concurrent falciparum parasitemia) from Indonesia were evaluable. Also, 84.3% (415/492) and 66.6% (209/314) of patients with monoinfection were gametocytemic at enrollment, respectively. The ratio of gametocytemia to asexual parasitemia did not differ between acute and recurrent infections (P = .48 in Thailand, P = .08 in Indonesia). High asexual parasitemia was associated with an increased risk of gametocytemia during follow-up in both locations. In Thailand, the cumulative incidence of gametocytemia between day 7 and day 42 following dihydroartemisinin + piperaquine (DHA + PIP) was 6.92% vs 29.1% following chloroquine (P < .001). In Indonesia, the incidence of gametocytemia was 33.6% following artesunate + amodiaquine (AS + AQ), 7.42% following artemether + lumefantrine, and 6.80% following DHA + PIP (P < .001 for DHA + PIP vs AS + AQ). CONCLUSIONS: P. vivax gametocyte carriage mirrors asexual-stage infection. Prevention of relapses, particularly in those with high asexual parasitemia, is likely the most important strategy for interrupting P. vivax transmission. |
| spellingShingle | Douglas, N Simpson, J Phyo, A Siswantoro, H Hasugian, A Kenangalem, E Poespoprodjo, JR Singhasivanon, P Anstey, N White, N Tjitra, E Nosten, F Price, R Gametocyte dynamics and the role of drugs in reducing the transmission potential of Plasmodium vivax. |
| title | Gametocyte dynamics and the role of drugs in reducing the transmission potential of Plasmodium vivax. |
| title_full | Gametocyte dynamics and the role of drugs in reducing the transmission potential of Plasmodium vivax. |
| title_fullStr | Gametocyte dynamics and the role of drugs in reducing the transmission potential of Plasmodium vivax. |
| title_full_unstemmed | Gametocyte dynamics and the role of drugs in reducing the transmission potential of Plasmodium vivax. |
| title_short | Gametocyte dynamics and the role of drugs in reducing the transmission potential of Plasmodium vivax. |
| title_sort | gametocyte dynamics and the role of drugs in reducing the transmission potential of plasmodium vivax |
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