Assessment of asymptomatic Plasmodium spp. infection by detection of parasite DNA in residents of an extra-Amazonian region of Brazil

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art_ALENCAR_Assessment_of_asymptomatic_Plasmodium_spp_infection_by_detection_2018.PDF (1.48 MB)
Citações na Scopus
13
Tipo de produção
article
Data de publicação
2018
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
BIOMED CENTRAL LTD
Autores
ALENCAR, Filomena E. C. de
CERUTTI JUNIOR, Crispim
BUERY, Julyana Cerqueira
FUX, Blima
REZENDE, Helder Ricas
DUARTE, Ana Maria Ribeiro de Castro
MEDEIROS-SOUSA, Antonio Ralph
MIRANDA, Angelica Espinosa
Citação
MALARIA JOURNAL, v.17, article ID 113, 11p, 2018
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background: The hypotheses put forward to explain the malaria transmission cycle in extra-Amazonian Brazil, an area of very low malaria incidence, are based on either a zoonotic scenario involving simian malaria, or a scenario in which asymptomatic carriers play an important role. Objectives: To determine the incidence of asymptomatic infection by detecting Plasmodium spp. DNA and its role in residual malaria transmission in a non-Amazonian region of Brazil. Methods: Upon the report of the first malaria case in 2010 in the Atlantic Forest region of the state of Espirito Santo, inhabitants within a 2 km radius were invited to participate in a follow-up study. After providing signed informed consent forms, inhabitants filled out a questionnaire and gave blood samples for PCR, and thick and thin smears. Followup visits were performed every 3 months over a 21 month period, when new samples were collected and information was updated. Results: Ninety-two individuals were initially included for follow-up. At the first collection, all of them were clearly asymptomatic. One individual was positive for Plasmodium vivax, one for Plasmodium malariae and one for both P. vivax and P. malariae, corresponding to a prevalence of 3.4% (2.3% for each species). During follow-up, four new PCR-positive cases (two for each species) were recorded, corresponding to an incidence of 2.5 infections per 100 personyears or 1.25 infections per 100 person-years for each species. A mathematical transmission model was applied, using a low frequency of human carriers and the vector density in the region, and calculated based on previous studies in the same locality whose results were subjected to a linear regression. This analysis suggests that the transmission chain is unlikely to be based solely on human carriers, regardless of whether they are symptomatic or not. Conclusion: The low incidence of cases and the low frequency of asymptomatic malaria carriers investigated make it unlikely that the transmission chain in the region is based solely on human hosts, as cases are isolated one from another by hundreds of kilometers and frequently by long periods of time, reinforcing instead the hypothesis of zoonotic transmission.
Palavras-chave
Malaria, Plasmodium vivax, Plasmodium malariae, Asymptomatic carrier, PCR
URI
https://observatorio.fm.usp.br/handle/OPI/26585
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Coleções
Artigos e Materiais de Revistas Científicas - IMT
Artigos e Materiais de Revistas Científicas - LIM/49
Artigos e Materiais de Revistas Científicas - ODS/03