Plasmodium falciparum gametocyte dynamics in areas of different malaria endemicity

doi:10.1186/1475-2875-7-249

Malaria Journal
Volume 7

Viewing options:

Abstract
Full text
PDF (399KB)

Associated material:

Related literature:

Articles citing this article
on BioMed Central
on Google Scholar
on ISI Web of Science
on PubMed Central
Other articles by authors
on Google Scholar

Stepniewska K
Price RN
Sutherland CJ
Drakeley CJ
von Seidlein L
Nosten F
White NJ

on PubMed

Stepniewska K
Price RN
Sutherland CJ
Drakeley CJ
von Seidlein L
Nosten F
White NJ
Related articles/pages
on Google

on Google Scholar

on PubMed

Tools:

Post to:

Research

Plasmodium falciparum gametocyte dynamics in areas of different malaria endemicity

Kasia Stepniewska¹^,2 , Ric N Price²^,3 , Colin J Sutherland⁴ , Chris J Drakeley⁴ , Lorenz von Seidlein¹^,4^,5 , Francois Nosten¹^,2^,6 and Nicholas J White¹^,2

¹Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Road, Bangkok 10400, Thailand

²Centre for Clinical Vaccinology and Tropical Medicine, Churchill Hospital, Oxford, UK

³International Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, NT, Australia

⁴Department of Infectious & Tropical Diseases, London School of Hygiene and Tropical Medicine, UK

⁵Joint Malaria Programme, Tanga, Tanzania

⁶Shoklo Malaria Research Unit, Tak, Thailand

author email corresponding author email

Malaria Journal 2008, 7:249doi:10.1186/1475-2875-7-249


Published:	3 December 2008

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.