Title:
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The complex relationship of exposure to new Plasmodium
infections and incidence of clinical malaria in Papua New Guinea
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Author:
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Hofmann, Natalie E.; Karl, Stephan; Wampfler, Rahel; Kiniboro, Benson; Teliki, Albina; Iga, Jonah; Waltmann, Andreea; Betuela, Inoni; Felger, Ingrid; Robinson, Leanne J.; Mueller, Ivo
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Abstract:
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The molecular force of blood-stage infection (molFOB) is a
quantitative surrogate metric for malaria transmission at
population level and for exposure at individual level.
Relationships between molFOB, parasite prevalence and clinical
incidence were assessed in a treatment-to-reinfection cohort,
where P.vivax (Pv) hypnozoites were eliminated in half the
children by primaquine (PQ). Discounting relapses, children
acquired equal numbers of new P. falciparum (Pf) and Pv
blood-stage infections/year (Pf-molFOB = 0-18, Pv-molFOB = 0-23)
resulting in comparable spatial and temporal patterns in
incidence and prevalence of infections. Including relapses,
Pv-molFOB increased >3 fold (relative to PQ-treated children)
showing greater heterogeneity at individual (Pv-molFOB = 0-36)
and village levels. Pf- and Pv-molFOB were strongly associated
with clinical episode risk. Yearly Pf clinical incidence rate
(IR = 0.28) was higher than for Pv (IR = 0.12) despite lower
Pf-molFOB. These relationships between molFOB, clinical
incidence and parasite prevalence reveal a comparable decline in
Pf and Pv transmission that is normally hidden by the high
burden of Pv relapses. CLINICAL TRIAL REGISTRATION:
ClinicalTrials.gov NCT02143934. |
Subject(s):
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-Malària -Papua Nova Guinea -Plasmodium vivax -Malaria -Papua New Guinea -Plasmodium vivax |
Rights:
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cc by (c) Hofmann et al., 2017
http://creativecommons.org/licenses/by/4.0/ |
Document type:
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Article Article - Published version |
Published by:
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eLife Sciences Publications
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