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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Moderate effect of artemisinin-based combination therapy on transmission of Plasmodium falciparum
Journal of Infectious Diseases, Volume 193, No. 8, Year 2006
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Description
Background. Artemisin in-based combination therapy (ACT) reduces microscopically confirmed gametocytemia and mosquito infection. However, molecular techniques have recently revealed high prevalences of submicroscopic gametocytemia. Our objective here was to determine the effect of sulfadoxine-pyrimethaminc (SP) monotherapy and treatment with SP plus amodiaquine (AQ), SP plus artesunate (AS), and artemether-lumefantrine (AL; Coartem) on submicroscopic gametocytemia and infectiousness. Method;. Kenyan children (n = 528) 6 months-10 years of age were randomized to 4 treatment arms. Gametocytemia was determined by both microscopy and Pfs25 RNA-based quantitative nucleic acid sequence-based amplification (Pfs25 QT-NASBA). Transmission was determined by membrane-feeding assays. Results. Gametocyte prevalence, as determined by Pfs25 QT-NASBA, was 89.4% (219/245) at enrollment and decreased after treatment with SP plus AS, SP plus AQ, and AL. Membrane-feeding assays for a group of randomly selected children revealed that the proportion of infectious children was as much as 4-fold higher than expected when based on microscopy. ACT did not significantly reduce the proportion of infectious children but did reduce the proportion of infected mosquitoes. Conclusions. Submicroscopic gametocytemia is common after treatment and contributes considerably to mosquito infection. Our findings should be interpreted in the context of transmission intensity, but the effect of ACT on malaria transmission appears to be moderate and restricted to the duration of gametocyte carriage and the proportion of mosquitoes that are infected by carriers. © 2006 by the Infectious Diseases Society of America. All rights reserved.
Authors & Co-Authors
Bousema, J. Teun
Unknown Affiliation
Schneider, Petra
Unknown Affiliation
Gouagna, Louis Clément
Unknown Affiliation
Drakeley, Chris J.
Unknown Affiliation
Tostmann, Alma
Unknown Affiliation
Houben, Rein M.G.J.
Unknown Affiliation
Githure, John Ichamwenge
Unknown Affiliation
Ord, Rosalynn Louise
Unknown Affiliation
Sutherland, Colin J.
Unknown Affiliation
Omar, Sabah Ahmed
Unknown Affiliation
Sauerwein, Robert W.
Unknown Affiliation
Statistics
Citations: 223
Authors: 11
Affiliations: 6
Identifiers
Doi:
10.1086/503051
ISSN:
00221899
Research Areas
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study
Study Approach
Quantitative