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  • Liljander, AnneInfectious Diseases Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden (författare)

Influences of intermittent preventive treatment and persistent multiclonal Plasmodium falciparum infections on clinical malaria risk

  • Artikel/kapitelEngelska2010

Förlag, utgivningsår, omfång ...

  • 2010-10-27
  • Public Library of Science (PLoS),2010
  • printrdacarrier

Nummerbeteckningar

  • LIBRIS-ID:oai:DiVA.org:oru-25568
  • https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-25568URI
  • https://doi.org/10.1371/journal.pone.0013649DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:121511852URI

Kompletterande språkuppgifter

  • Språk:engelska
  • Sammanfattning på:engelska

Ingår i deldatabas

Klassifikation

  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • BACKGROUND: Intermittent preventive treatment (IPT) of malaria involves administration of curative doses of antimalarials at specified time points to vulnerable populations in endemic areas, regardless whether a subject is known to be infected. The effect of this new intervention on the development and maintenance of protective immunity needs further understanding. We have investigated how seasonal IPT affects the genetic diversity of Plasmodium falciparum infections and the risk of subsequent clinical malaria.MATERIAL AND METHODS: The study included 2227 Ghanaian children (3-59 months) who were given sulphadoxine-pyrimethamine (SP) bimonthly, artesunate plus amodiaquine (AS+AQ) monthly or bimonthly, or placebo monthly for six months spanning the malaria transmission season. Blood samples collected at three post-interventional surveys were analysed by genotyping of the polymorphic merozoite surface protein 2 gene. Malaria morbidity and anaemia was monitored during 12 months follow-up.RESULTS: Monthly IPT with AS+AQ resulted in a marked reduction in number of concurrent clones and only children parasite negative just after the intervention period developed clinical malaria during follow-up. In the placebo group, children without parasites as well as those infected with ≥2 clones had a reduced risk of subsequent malaria. The bimonthly SP or AS+AQ groups had similar number of clones as placebo after intervention; however, diversity and parasite negativity did not predict the risk of malaria. An interaction effect showed that multiclonal infections were only associated with protection in children without intermittent treatment.CONCLUSION: Molecular typing revealed effects of the intervention not detected by ordinary microscopy. Effective seasonal IPT temporarily reduced the prevalence and genetic diversity of P. falciparum infections. The reduced risk of malaria in children with multiclonal infections only seen in untreated children suggests that persistence of antigenically diverse P. falciparum infections is important for the maintenance of protective malaria immunity in high transmission settings.

Ämnesord och genrebeteckningar

  • Medicine
  • Medicin

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Chandramohan, DanielInfectious and Tropical Diseases Department, London School of Hygiene and Tropical Medicine, London, United Kingdom (författare)
  • Kweku, MargaretInfectious and Tropical Diseases Department, London School of Hygiene and Tropical Medicine, London, United Kingdom; Ghana Health Service, University of Ghana, Accra, Ghana (författare)
  • Olsson, DanielKarolinska Institutet (författare)
  • Montgomery, Scott M.Karolinska Institutet,Örebro universitet,Institutionen för hälsovetenskap och medicin,Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Department of Primary Care and Social Medicine, Charing Cross Hospital, Imperial College, London, United Kingdom,Clinical Epidemiology and Biostatistics(Swepub:oru)smy (författare)
  • Greenwood, BrianClinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Department of Primary Care and Social Medicine, Charing Cross Hospital, Imperial College, London, United Kingdom (författare)
  • Färnert, AnnaKarolinska Institutet (författare)
  • Infectious Diseases Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, SwedenInfectious and Tropical Diseases Department, London School of Hygiene and Tropical Medicine, London, United Kingdom (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:PloS one: Public Library of Science (PLoS)5:101932-6203

Internetlänk

Hitta via bibliotek

  • PloS one (Sök värdpublikationen i LIBRIS)

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