학술논문
The temporal dynamics of Plasmodium species infection after artemisinin-based combination therapy (ACT) among asymptomatic children in the Hohoe municipality, Ghana.
Document Type
Article
Author
Ansah, Felix; Nyame, Kwamina; Laryea, Rukaya; Owusu, Richard; Amon, Denick; Boyetey, Mark-Jefferson Buer; Ayeke, Dzidzor; Razak, Nasibatu; Kornu, Victor E.; Ashitei, Sarah; Owusu-Appiah, Caleb; Chirawurah, Jersley D.; Abugri, James; Aniweh, Yaw; Opoku, Nicholas; Sutherland, Colin J.; Binka, Fred N.; Kweku, Margaret; Awandare, Gordon A.; Dinko, Bismarck
Source
Subject
*ASYMPTOMATIC patients
*PLASMODIUM
*PLASMODIUM vivax
*PLASMODIUM falciparum
*POLYMERASE chain reaction
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Language
ISSN
1475-2875
Abstract
Background: The routine surveillance of asymptomatic malaria using nucleic acid-based amplification tests is essential in obtaining reliable data that would inform malaria policy formulation and the implementation of appropriate control measures. Methods: In this study, the prevalence rate and the dynamics of Plasmodium species among asymptomatic children (n = 1697) under 5 years from 30 communities within the Hohoe municipality in Ghana were determined. Results and discussion: The observed prevalence of Plasmodium parasite infection by polymerase chain reaction (PCR) was 33.6% (571/1697), which was significantly higher compared to that obtained by microscopy [26.6% (451/1697)] (P < 0.0001). Based on species-specific analysis by nested PCR, Plasmodium falciparum infection [33.6% (570/1697)] was dominant, with Plasmodium malariae, Plasmodium ovale and Plasmodium vivax infections accounting for 0.1% (1/1697), 0.0% (0/1697), and 0.0% (0/1697), respectively. The prevalence of P. falciparum infection among the 30 communities ranged from 0.0 to 82.5%. Following artesunate-amodiaquine (AS + AQ, 25 mg/kg) treatment of a sub-population of the participants (n = 184), there was a substantial reduction in Plasmodium parasite prevalence by 100% and 79.2% on day 7 based on microscopy and nested PCR analysis, respectively. However, there was an increase in parasite prevalence from day 14 to day 42, with a subsequent decline on day 70 by both microscopy and nested PCR. For parasite clearance rate analysis, we found a significant proportion of the participants harbouring residual Plasmodium parasites or parasite genomic DNA on day 1 [65.0% (13/20)], day 2 [65.0% (13/20)] and day 3 [60.0% (12/20)] after initiating treatment. Of note, gametocyte carriage among participants was low before and after treatment. Conclusion: Taken together, the results indicate that a significant number of individuals could harbour residual Plasmodium parasites or parasite genomic DNA after treatment. The study demonstrates the importance of routine surveillance of asymptomatic malaria using sensitive nucleic acid-based amplification techniques. [ABSTRACT FROM AUTHOR]