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Plasmodium falciparum gametocyte dynamics in areas of different malaria endemicity

Stepniewska, Kasia, Price, Ric N., Sutherland, Colin, J., Drakeley, Chris J., von Seidlein, Lorenz, Nosten, Francois and White, Nicholas J. (2008). Plasmodium falciparum gametocyte dynamics in areas of different malaria endemicity. Malaria Journal,7:249-270.

Document type: Journal Article
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IRMA ID 10202xPUB30
Title Plasmodium falciparum gametocyte dynamics in areas of different malaria endemicity
Author Stepniewska, Kasia
Price, Ric N.
Sutherland, Colin, J.
Drakeley, Chris J.
von Seidlein, Lorenz
Nosten, Francois
White, Nicholas J.
Journal Name Malaria Journal
Publication Date 2008
Volume Number 7
ISSN 1475-2875   (check CDU catalogue  open catalogue search in new window)
Start Page 249
End Page 270
Total Pages 22
Place of Publication United Kingdom
Publisher BioMed Central Ltd.
Field of Research 1108 - Medical Microbiology
HERDC Category C1 - Journal Article (DEST)
Abstract Background
The aim of this study was to identify and compare factors associated with Plasmodium falciparum gametocyte carriage in three regions of differing malaria endemicity.

Methods
Retrospective data from Thailand, The Gambia and Tanzania were used. The data came from large prospective field-based clinical trials, which investigated gametocyte carriage after different anti-malarial drug treatments.

Results
Gametocytaemia was detected during the observation period in 12% of patients (931 out of 7548) in Thailand, 34% (683 out of 2020) in The Gambia, and 31% (430 out of 1400) in Tanzania (p < 0.001). Approximately one third (33%, 680/2044) of the patients with gametocytaemia during the observation period, already had patent gametocytaemia at enrolment (day 0 or day 1): 35% (318/931) in Thailand, 37% (250/683) in The Gambia, 26% (112/430) in Tanzania. Maximum gametocytaemia was usually observed on or before the seventh day after starting treatment (93% in Thailand, 70% in Tanzania and 78% in The Gambia). Lowest gametocyte carriage rates were observed following treatment with artemisinin derivatives, while sulphadoxine-pyrimethamine (SP) was associated with significantly greater development of gametocytaemia than other drug treatments (p < 0.001). The duration of gametocyte carriage was shorter in Thailand by 86% and Tanzania by 65% than in The Gambia. Gametocyte carriage was 27% longer among people presenting with anaemia, and was shorter in duration among patients who received artemisinin derivatives, by 27% in Thailand and by 71% in Tanzania and The Gambia.

Conclusion
This study confirms the independent association of gametocytaemia with anaemia, and the significantly lower prevalence and duration of gametocyte carriage following treatment with an artemisinin derivative. The large differences in gametocyte carriage rates between regions with different levels of malaria transmission suggest that drug interventions to prevent transmission will have different effects in different places.
DOI http://dx.doi.org/10.1186/1475-2875-7-249   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)


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