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Sustained malaria control over an 8-year period in Papua New Guinea: The challenge of low-density asymptomatic plasmodium infections

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journal contribution
posted on 2024-06-14, 07:17 authored by C Koepfli, M Ome-Kaius, S Jally, E Malau, S Maripal, J Ginny, L Timinao, JH Kattenberg, T Obadia, M White, P Rarau, N Senn, Alyssa BarryAlyssa Barry, JW Kazura, I Mueller, LJ Robinson
© 2017 The Author. Background. Te scale-up of effective malaria control in the last decade has resulted in a substantial decline in the incidence of clinical malaria in many countries. Te effects on the proportions of asymptomatic and submicroscopic infections and on transmission potential are yet poorly understood. Methods. In Papua New Guinea, vector control has been intensifed since 2008, and improved diagnosis and treatment was introduced in 2012. Cross-sectional surveys were conducted in Madang Province in 2006 (with 1280 survey participants), 2010 (with 2117 participants), and 2014 (with 2516 participants). Infections were quantifed by highly sensitive quantitative polymerase chain reaction (PCR) analysis, and gametocytes were quantifed by reverse-transcription qPCR analysis. Results. Plasmodium falciparum prevalence determined by qPCR decreased from 42% in 2006 to 9% in 2014. Te P. vivax prevalence decreased from 42% in 2006 to 13% in 2010 but then increased to 20% in 2014. Parasite densities decreased 5-fold from 2006 to 2010; 72% of P. falciparum and 87% of P. vivax infections were submicroscopic in 2014. Gametocyte density and positivity correlated closely with parasitemia, and population gametocyte prevalence decreased 3-fold for P. falciparum and 29% for P. vivax from 2010 to 2014. Conclusions. Sustained control has resulted in reduced malaria transmission potential, but an increasing proportion of gametocyte carriers are asymptomatic and submicroscopic and represent a challenge to malaria control.

History

Journal

Journal of Infectious Diseases

Volume

216

Pagination

1434-1443

Location

Oxford, Eng.

Open access

  • Yes

ISSN

0022-1899

eISSN

1537-6613

Language

eng

Publication classification

C1 Refereed article in a scholarly journal

Issue

11

Publisher

Oxford Academic

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