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The persistence and oscillations of submicroscopic Plasmodium falciparum and Plasmodium vivax infections over time in Vietnam: an open cohort study

The Lancet infectious diseases, 2018-05, Vol.18 (5), p.565-572 [Peer Reviewed Journal]

2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license ;Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved. ;Copyright Elsevier Limited May 2018 ;2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license 2018 ;ISSN: 1473-3099 ;EISSN: 1474-4457 ;DOI: 10.1016/S1473-3099(18)30046-X ;PMID: 29398388

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Title:
The persistence and oscillations of submicroscopic Plasmodium falciparum and Plasmodium vivax infections over time in Vietnam: an open cohort study
Author: Nguyen, Thuy-Nhien ; von Seidlein, Lorenz ; Nguyen, Tuong-Vy ; Truong, Phuc-Nhi ; Hung, Son Do ; Pham, Huong-Thu ; Nguyen, Tam-Uyen ; Le, Thanh Dong ; Dao, Van Hue ; Mukaka, Mavuto ; Day, Nicholas PJ ; White, Nicholas J ; Dondorp, Arjen M ; Thwaites, Guy E ; Hien, Tran Tinh
Subjects: Adult ; Blood ; Charities ; Cohort Studies ; Data analysis ; Density ; Diagnostic systems ; Diagnostic tests ; Disease transmission ; Female ; Humans ; Infections ; Malaria ; Malaria, Falciparum - epidemiology ; Malaria, Falciparum - parasitology ; Malaria, Vivax - epidemiology ; Malaria, Vivax - parasitology ; Male ; Microscopy ; Middle Aged ; Mosquitoes ; Oscillations ; Parasitemia ; Parasites ; Parasitology ; Plasmodium ; Plasmodium falciparum ; Plasmodium vivax ; Polls & surveys ; Public health ; Seasons ; Studies ; Towns ; Vector-borne diseases ; Vietnam - epidemiology ; Writing
Is Part Of: The Lancet infectious diseases, 2018-05, Vol.18 (5), p.565-572
Description: A substantial proportion of Plasmodium species infections are asymptomatic with densities too low to be detectable with standard diagnostic techniques. The importance of such asymptomatic plasmodium infections in malaria transmission is probably related to their duration and density. To explore the duration of asymptomatic plasmodium infections and changes in parasite densities over time, a cohort of participants who were infected with Plasmodium parasites was observed over a 2-year follow-up period. In this open cohort study, inhabitants of four villages in Vietnam were invited to participate in baseline and subsequent 3-monthly surveys up to 24 months, which included the collection of venous blood samples. Samples were batch-screened using ultra-sensitive (u)PCR (lower limit of detection of 22 parasites per mL). Participants found to be infected by uPCR during any of these surveys were invited to join a prospective cohort and provide monthly blood samples. We estimated the persistence of Plasmodium falciparum and Plasmodium vivax infections and changes in parasite densities over a study period of 24 months. Between Dec 1, 2013, and Jan 8, 2016, 356 villagers participated in between one and 22 surveys. These study participants underwent 4248 uPCR evaluations (11·9 tests per participant). 1874 (32%) of 4248 uPCR tests indicated a plasmodium infection; 679 (36%) of 1874 tests were P falciparum monoinfections, 507 (27%) were P vivax monoinfections, 463 (25%) were co-infections with P falciparum and P vivax, and 225 (12%) were indeterminate species of Plasmodium. The median duration of P falciparum infection was 2 months (IQR 1–3); after accounting for censoring, participants had a 20% chance of having parasitaemia for 4 months or longer. The median duration of P vivax infection was 6 months (3–9), and participants had a 59% chance of having parasitaemia for 4 months or longer. The parasite densities of persistent infections oscillated; following ultralow-density infections, high-density infections developed frequently. Persistent largely asymptomatic P vivax and P falciparum infections are common in this area of low seasonal malaria transmission. Infections with low-density parasitaemias can develop into much higher density infections at a later time, which are likely to sustain malaria endemicity. The Wellcome Trust, Bill & Melinda Gates Foundation.
Publisher: United States: Elsevier Ltd
Language: English
Identifier: ISSN: 1473-3099
EISSN: 1474-4457
DOI: 10.1016/S1473-3099(18)30046-X
PMID: 29398388
Source: MEDLINE
ProQuest Central

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The persistence and oscillations of submicroscopic Plasmodium falciparum and Plasmodium vivax infections over time in Vietnam: an open cohort study

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