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Predominance of asymptomatic and sub-microscopic infections characterizes the Plasmodium gametocyte reservoir in the Peruvian Amazon

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dc.contributor.author Rovira-Vallbona, Eduard
dc.contributor.author Contreras-Mancilla, Juan José
dc.contributor.author Ramirez, Roberson
dc.contributor.author Guzman Guzman, Mitchel Anthony
dc.contributor.author Carrasco Escobar, Gabriel
dc.contributor.author Llanos Cuentas, Elmer Alejandro
dc.contributor.author Vinetz, Joseph Michael
dc.contributor.author Gamboa Vilela, Dionicia Baziliza
dc.contributor.author Rosanas-Urgell, Anna
dc.date.accessioned 2019-01-25T15:28:08Z
dc.date.available 2019-01-25T15:28:08Z
dc.date.issued 2017
dc.identifier.uri https://hdl.handle.net/20.500.12866/4728
dc.description.abstract Malaria transmission requires that Anopheles mosquitoes ingest Plasmodium gametocyte stages circulating in the human bloodstream. In the context of malaria elimination, understanding the epidemiology of gametocytes relative to all Plasmodium infections and the contribution of asymptomatic and sub-microscopic parasite carriers to the gametocyte reservoir is necessary, especially in low endemic settings with predominance of P.vivax. A 13-month longitudinal study was conducted in two communities (n = 1935 individuals) of Loreto Department, Peru, with five active screenings for Plasmodium infections and gametocyte stages by quantitative real-time PCR (qPCR) and reverse transcription (RT)-qPCR, respectively. Parasite prevalence by qPCR was 7.2% for P.vivax (n = 520/7235; range by survey 6.0%-8.1%) and 3.2% for P.falciparum (n = 235/7235; range by survey 0.4%-7.7%). Sub-microscopic infections accounted for 73.5% of P.vivax (range by survey 60%-89%) and almost the totality of P.falciparum cases. Gametocytes were found in 28.4% P.vivax infections (range by survey 18.7%-34.1%), with a peak of 61.5% in one community at the start of the transmission season. About 59.8% of all P.vivax gametocyte carriers were asymptomatic and 31.9% were sub-microscopic. Age patterns for gametocyte prevalence paralleled asexual stage infections and peaked among >15-25 year old individuals. Asexual parasite density was found to be the strongest predictor for P.vivax gametocyte presence in longitudinal multivariate analysis (odds ratio 2.33 [95% confidence interval 1.96, 2.78]; P<0.001). Despite significant differences in seasonality patterns and P.vivax prevalence found at the local scale, sub-microscopic and asymptomatic infections predominate and contribute significantly to the gametocyte reservoir in different communities of the Peruvian Amazon. Control and elimination campaigns need sensitive tools to detect all infections that escape routine malaria surveillance, which may contribute to maintain transmission in the region. en_US
dc.language.iso eng
dc.publisher Public Library of Science
dc.relation.ispartofseries PLoS Neglected Tropical Diseases
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Adolescent en_US
dc.subject Adult en_US
dc.subject Age Distribution en_US
dc.subject Aged en_US
dc.subject Aged, 80 and over en_US
dc.subject Animals en_US
dc.subject Anopheles en_US
dc.subject Asymptomatic Infections/epidemiology en_US
dc.subject Carrier State/epidemiology en_US
dc.subject Child en_US
dc.subject Child, Preschool en_US
dc.subject Female en_US
dc.subject Humans en_US
dc.subject Infant en_US
dc.subject Longitudinal Studies en_US
dc.subject Malaria/epidemiology/pathology en_US
dc.subject Male en_US
dc.subject Middle Aged en_US
dc.subject Peru/epidemiology en_US
dc.subject Plasmodium falciparum/genetics/isolation & purification en_US
dc.subject Plasmodium vivax/genetics/isolation & purification en_US
dc.subject Prospective Studies en_US
dc.subject Real-Time Polymerase Chain Reaction en_US
dc.subject Young Adult en_US
dc.title Predominance of asymptomatic and sub-microscopic infections characterizes the Plasmodium gametocyte reservoir in the Peruvian Amazon en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1371/journal.pntd.0005674
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.06
dc.relation.issn 1935-2735


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