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Parasitology ; 141(14): 1880-90, 2014 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-24837880

RESUMEN

During a longitudinal study investigating the dynamics of malaria in Ugandan lakeshore communities, a consistently high malaria prevalence was observed in young children despite regular treatment. To explore the short-term performance of artemether-lumefantrine (AL), a pilot investigation into parasite carriage after treatment(s) was conducted in Bukoba village. A total of 163 children (aged 2-7 years) with a positive blood film and rapid antigen test were treated with AL; only 8.7% of these had elevated axillary temperatures. On day 7 and then on day 17, 40 children (26.3%) and 33 (22.3%) were positive by microscopy, respectively. Real-time PCR analysis demonstrated that multi-species Plasmodium infections were common at baseline, with 41.1% of children positive for Plasmodium falciparum/Plasmodium malariae, 9.2% for P. falciparum/ Plasmodium ovale spp. and 8.0% for all three species. Moreover, on day 17, 39.9% of children infected with falciparum malaria at baseline were again positive for the same species, and 9.2% of those infected with P. malariae at baseline were positive for P. malariae. Here, chronic multi-species malaria infections persisted in children after AL treatment(s). Better point-of-care diagnostics for non-falciparum infections are needed, as well as further investigation of AL performance in asymptomatic individuals.


Asunto(s)
Antimaláricos/uso terapéutico , Artemisininas/uso terapéutico , Etanolaminas/uso terapéutico , Fluorenos/uso terapéutico , Malaria/diagnóstico , Plasmodium/aislamiento & purificación , Arteméter , Niño , Preescolar , Coinfección , Pruebas Diagnósticas de Rutina , Quimioterapia Combinada , Femenino , Estudios de Seguimiento , Humanos , Estudios Longitudinales , Lumefantrina , Malaria/tratamiento farmacológico , Malaria/epidemiología , Malaria/parasitología , Masculino , Plasmodium/genética , Plasmodium/inmunología , Plasmodium falciparum/genética , Plasmodium falciparum/inmunología , Plasmodium falciparum/aislamiento & purificación , Plasmodium ovale/genética , Plasmodium ovale/inmunología , Plasmodium ovale/aislamiento & purificación , Sistemas de Atención de Punto , Prevalencia , Uganda/epidemiología
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