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Hyper-prevalence of submicroscopic Plasmodium falciparum infections in a rural area of western Kenya with declining malaria cases.
Ochwedo, Kevin O; Omondi, Collince J; Magomere, Edwin O; Olumeh, Julius O; Debrah, Isaiah; Onyango, Shirley A; Orondo, Pauline W; Ondeto, Benyl M; Atieli, Harrysone E; Ogolla, Sidney O; Githure, John; Otieno, Antony C A; Githeko, Andrew K; Kazura, James W; Mukabana, Wolfgang R; Guiyan, Yan.
Afiliação
  • Ochwedo KO; Department of Biology, Faculty of Science and Technology, University of Nairobi, Nairobi, Kenya. kevinochwedo@gmail.com.
  • Omondi CJ; Sub-Saharan Africa International Centre for Excellence in Malaria Research, Homa Bay, Kenya. kevinochwedo@gmail.com.
  • Magomere EO; Department of Biology, Faculty of Science and Technology, University of Nairobi, Nairobi, Kenya.
  • Olumeh JO; Sub-Saharan Africa International Centre for Excellence in Malaria Research, Homa Bay, Kenya.
  • Debrah I; Department of Biochemistry and Molecular Biology, Egerton University, Njoro, Kenya.
  • Onyango SA; Department of Biology, Faculty of Science and Technology, University of Nairobi, Nairobi, Kenya.
  • Orondo PW; Sub-Saharan Africa International Centre for Excellence in Malaria Research, Homa Bay, Kenya.
  • Ondeto BM; West Africa Centre for Cell Biology of Infectious Pathogen, Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana.
  • Atieli HE; Sub-Saharan Africa International Centre for Excellence in Malaria Research, Homa Bay, Kenya.
  • Ogolla SO; Sub-Saharan Africa International Centre for Excellence in Malaria Research, Homa Bay, Kenya.
  • Githure J; Department of Biology, Faculty of Science and Technology, University of Nairobi, Nairobi, Kenya.
  • Otieno ACA; Sub-Saharan Africa International Centre for Excellence in Malaria Research, Homa Bay, Kenya.
  • Githeko AK; Sub-Saharan Africa International Centre for Excellence in Malaria Research, Homa Bay, Kenya.
  • Kazura JW; Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya.
  • Mukabana WR; Sub-Saharan Africa International Centre for Excellence in Malaria Research, Homa Bay, Kenya.
  • Guiyan Y; Department of Biology, Faculty of Science and Technology, University of Nairobi, Nairobi, Kenya.
Malar J ; 20(1): 472, 2021 Dec 20.
Article em En | MEDLINE | ID: mdl-34930283
BACKGROUND: The gold standard for diagnosing Plasmodium falciparum infection is microscopic examination of Giemsa-stained peripheral blood smears. The effectiveness of this procedure for infection surveillance and malaria control may be limited by a relatively high parasitaemia detection threshold. Persons with microscopically undetectable infections may go untreated, contributing to ongoing transmission to mosquito vectors. The purpose of this study was to determine the magnitude and determinants of undiagnosed submicroscopic P. falciparum infections in a rural area of western Kenya. METHODS: A health facility-based survey was conducted, and 367 patients seeking treatment for symptoms consistent with uncomplicated malaria in Homa Bay County were enrolled. The frequency of submicroscopic P. falciparum infection was measured by comparing the prevalence of infection based on light microscopic inspection of thick blood smears versus real-time polymerase chain reaction (RT-PCR) targeting P. falciparum 18S rRNA gene. Long-lasting insecticidal net (LLIN) use, participation in nocturnal outdoor activities, and gender were considered as potential determinants of submicroscopic infections. RESULTS: Microscopic inspection of blood smears was positive for asexual P. falciparum parasites in 14.7% (54/367) of cases. All of these samples were confirmed by RT-PCR. 35.8% (112/313) of blood smear negative cases were positive by RT-PCR, i.e., submicroscopic infection, resulting in an overall prevalence by RT-PCR alone of 45.2% compared to 14.7% for blood smear alone. Females had a higher prevalence of submicroscopic infections (35.6% or 72 out of 202 individuals, 95% CI 28.9-42.3) compared to males (24.2%, 40 of 165 individuals, 95% CI 17.6-30.8). The risk of submicroscopic infections in LLIN users was about half that of non-LLIN users (OR = 0.59). There was no difference in the prevalence of submicroscopic infections of study participants who were active in nocturnal outdoor activities versus those who were not active (OR = 0.91). Patients who participated in nocturnal outdoor activities and use LLINs while indoors had a slightly higher risk of submicroscopic infection than those who did not use LLINs (OR = 1.48). CONCLUSION: Microscopic inspection of blood smears from persons with malaria symptoms for asexual stage P. falciparum should be supplemented by more sensitive diagnostic tests in order to reduce ongoing transmission of P. falciparum parasites to local mosquito vectors.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Contexto em Saúde: 1_ASSA2030 / 2_ODS3 / 3_ND Problema de saúde: 1_doencas_transmissiveis / 2_enfermedades_transmissibles / 3_malaria / 3_neglected_diseases / 3_zoonosis Assunto principal: Plasmodium falciparum / População Rural / Malária Falciparum / Reação em Cadeia da Polimerase em Tempo Real / Doenças não Diagnosticadas / Microscopia Tipo de estudo: Prevalence_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude Limite: Adolescent / Adult / Aged / Aged80 / Child / Child, preschool / Female / Humans / Infant / Male País/Região como assunto: Africa Idioma: En Revista: Malar J Assunto da revista: MEDICINA TROPICAL Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Quênia

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Contexto em Saúde: 1_ASSA2030 / 2_ODS3 / 3_ND Problema de saúde: 1_doencas_transmissiveis / 2_enfermedades_transmissibles / 3_malaria / 3_neglected_diseases / 3_zoonosis Assunto principal: Plasmodium falciparum / População Rural / Malária Falciparum / Reação em Cadeia da Polimerase em Tempo Real / Doenças não Diagnosticadas / Microscopia Tipo de estudo: Prevalence_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude Limite: Adolescent / Adult / Aged / Aged80 / Child / Child, preschool / Female / Humans / Infant / Male País/Região como assunto: Africa Idioma: En Revista: Malar J Assunto da revista: MEDICINA TROPICAL Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Quênia
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