High proportions of asymptomatic and submicroscopic Plasmodium vivax infections in a peri-urban area of low transmission in the Brazilian Amazon

• Autor(a) principal: Almeida, Anne Cristine Gomes
• Data de Publicação: 2018
• Outros Autores: Kuehn, Andrea, Castro, Arthur J.M., Vítor-Silva, Sheila, Figueiredo, Erick F.G., Brasil, Larissa Wanderley, Brito, Marcelo Augusto Mota, S. Sampaio, Vanderson, Bassat, Quique, Felger, Ingrid, Tadei, Wanderli Pedro, Monteiro, Wuelton Marcelo, Mueller, Ivo, Lacerda, Marcus V. G.
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional do INPA
• Texto Completo: https://repositorio.inpa.gov.br/handle/1/15645
• topic: Adolescent; Adult; Aged; Amazonas; Asymptomatic Disease; Child; Controlled Study; Cross-sectional Study; Disease Carrier; Gametocyte; Household; Human; Human Cell; Major Clinical Study; Middle Aged; Nonhuman; Parasite Identification; Parasite Transmission; Parasitemia; Plasmodium Vivax; Plasmodium Vivax Malaria; Child, Preschool; Prevalence; Reverse Transcription Polymerase Chain Reaction; School Child; Urban Area; Young Adult; Asymptomatic Infection; Brasil; City Planning; Family Size; Female; Genetics; Isolation And Purification; Male; Microscopy; Parasitemia; Parasitology; Plasmodium Vivax Malaria; Questionnaires; Real-time Polymerase Chain Reaction; Transmission; Ultrastructure; Protozoal Dna; Adolescent; Adult; Asymptomatic Infections; Brasil; Child; Child, Preschool; Cross-sectional Studies; Disease Reservoirs; Dna, Protozoan; Family Characteristics; Female; Humans; Malaria, Vivax; Male; Microscopy; Middle Aged; Parasitemia; Plasmodium Vivax; Prevalence; Real-time Polymerase Chain Reaction; Surveys And Questionnaires; Urban Renewal; Young Adult

Background: Population-based studies conducted in Latin America have shown a high proportion of asymptomatic and submicroscopic malarial infections. Considering efforts aiming at regional elimination, it is important to investigate the role of this asymptomatic reservoir in malaria transmission in peri-urban areas. This study aimed to estimate the prevalence of Plasmodium spp. and gametocyte burden on symptomatic and asymptomatic infections in the Brazilian Amazon. Results: Two cross-sectional household surveys (CS) were conducted including all inhabitants in a peri-urban area of Manaus, western Amazonas State, Brazil. Malaria parasites were detected by light microscopy (LM) and qPCR. Sexual stages of Plasmodium spp. were detected by LM and RT-qPCR. A total of 4083 participants were enrolled during the two surveys. In CS1, the prevalence of Plasmodium vivax infections was 4.3% (86/2010) by qPCR and 1.6% (32/2010) by LM. Fifty percent (43/86) of P. vivax infected individuals (qPCR) carried P. vivax gametocytes. In CS2, 3.4% (70/2073) of participants had qPCR-detectable P. vivax infections, of which 42.9% (30/70) of infections were gametocyte positive. The P. vivax parasite density was associated with gametocyte carriage (P < 0.001). Sixty-seven percent of P. vivax infected individuals and 53.4% of P. vivax gametocyte carriers were asymptomatic. Conclusions: This study confirms a substantial proportion of asymptomatic and submicroscopic P. vivax infections in the study area. Most asymptomatic individuals carried gametocytes and presented low asexual parasitemia. This reservoir actively contributes to malaria transmission in the Brazilian Amazon, underscoring a need to implement more efficient control and elimination strategies. © 2018 The Author(s).