Detection of persistent Plasmodium spp. infections in Ugandan children after artemether-lumefantrine treatment

Betson, M; Sousa-Figueiredo, J C; Atuhaire, A; Arinaitwe, M; Adriko, M; Mwesigwa, G; Nabonge, J; Kabatereine, N B; Sutherland, C J; Stothard, J R

Abstract

During a longitudinal study investigating the dynamics of malaria in Ugandan lakeshore communities, a consistently high malaria prevalence was observed in young children despite regular treatment. To explore the short-term performance of artemether-lumefantrine (AL), a pilot investigation into parasite carriage after treatment(s) was conducted in Bukoba village. A total of 163 children (aged 2–7 years) with a positive blood film and rapid antigen test were treated with AL; only 8·7% of these had elevated axillary temperatures. On day 7 and then on day 17, 40 children (26·3%) and 33 (22·3%) were positive by microscopy, respectively. Real-time PCR analysis demonstrated that multi-species Plasmodium infections were common at baseline, with 41·1% of children positive for Plasmodium falciparum/Plasmodium malariae, 9·2% for P. falciparum/ Plasmodium ovale spp. and 8·0% for all three species. Moreover, on day 17, 39·9% of children infected with falciparum malaria at baseline were again positive for the same species, and 9·2% of those infected with P. malariae at baseline were positive for P. malariae. Here, chronic multi-species malaria infections persisted in children after AL treatment(s). Better point-of-care diagnostics for non-falciparum infections are needed, as well as further investigation of AL performance in asymptomatic individuals.

Citation

Betson, M., Sousa-Figueiredo, J. C., Atuhaire, A., Arinaitwe, M., Adriko, M., Mwesigwa, G., …Stothard, J. R. (in press). Detection of persistent Plasmodium spp. infections in Ugandan children after artemether-lumefantrine treatment. Parasitology, 141(14), 1880-90. https://doi.org/10.1017/S003118201400033X

• Journal Article Type: Article
• Acceptance Date: Feb 23, 2014
• Deposit Date: Nov 11, 2014
• Publicly Available Date: Feb 11, 2019
• Journal: Parasitology
• Print ISSN: 0031-1820
• Publisher: Cambridge University Press
• Peer Reviewed: Peer Reviewed
• Volume: 141
• Issue: 14
• Pages: 1880-90
• DOI: https://doi.org/10.1017/S003118201400033X
• Public URL: https://rvc-repository.worktribe.com/output/1405937
• Additional Information: Corporate Creators : Liverpool School of Tropical Medicine, LSHTM