Contribution of Asymptomatic Plasmodium Infections to the Transmission of Malaria in Kayin State, Myanmar.
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Chaumeau Victor, Kajeechiwa Ladda, Fustec Bénédicte, Landier Jordi, Naw Nyo Saw, Nay Hsel Saw, Phatharakokordbun Phabele, Kittiphanakun Prapan, Nosten Suphak, Thwin May Myo, Win Tun Saw, Wiladphaingern Jacher, Cottrell Gilles, Parker Daniel M, Minh Myo Chit, Kwansomboon Nittpha, Metaane Selma, Montazeau Céline, Kunjanwong Kitti, Sawasdichai Sunisa, Andolina Chiara, Ling Clare, Haohankhunnatham Warat, Christiensen Peter, Wanyatip Sunaree, Konghahong Kamonchanok, Cerqueira Dominique, Imwong Mallika, Dondorp Arjen M, Chareonviriyaphap Theeraphap, White Nicholas J, Nosten François H, Corbel Vincent
Аннотация
METHODS: MDA was conducted in 4 villages in Kayin State (Myanmar). Malaria mosquito vectors were captured 3 months before, during, and 3 months after MDA, and their Plasmodium infections were detected by polymerase chain reaction (PCR) analysis. The relationship between the entomological inoculation rate, the malaria prevalence in humans determined by ultrasensitive PCR, and MDA was characterized by generalized estimating equation regression.
RESULTS: Asymptomatic P. falciparum and Plasmodium vivax infections were cleared by MDA. The P. vivax entomological inoculation rate was reduced by 12.5-fold (95% confidence interval [CI], 1.6-100-fold), but the reservoir of asymptomatic P. vivax infections was reconstituted within 3 months, presumably because of relapses. This was coincident with a 5.3-fold (95% CI, 4.8-6.0-fold) increase in the vector infection rate.
CONCLUSION: Asymptomatic infections are a major source of malaria transmission in Southeast Asia.