Non-random distribution of Plasmodium Species infections and associated clinical features in children in the lake Victoria region, Kenya, 2012-2018.

IF 3.6 Q1 TROPICAL MEDICINE Tropical Medicine and Health Pub Date : 2024-08-05 DOI:10.1186/s41182-024-00622-3
Protus Omondi, Brian Musyoka, Takatsugu Okai, James Kongere, Wataru Kagaya, Chim W Chan, Mtakai Ngara, Bernard N Kanoi, Yasutoshi Kido, Jesse Gitaka, Akira Kaneko
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Abstract

Background: While Plasmodium falciparum (Pf) stands out as the most lethal malaria parasite species in humans, the impact of other species should not be dismissed. Moreover, there is a notable lack of understanding of mixed-species infections and their clinical implications.

Methods: We conducted eight school-based cross-sectional malariometric surveys in the Lake Victoria region of western Kenya between January-February 2012 and September-October 2018. In each survey, a minimum of 100 children aged 3 to 15 years were randomly chosen from a school in Ungoye village on the mainland and as well as from each school selected in every catchment area on Mfangano island. Plasmodium infection was determined by microscopy and nested polymerase chain reaction (PCR). The multiple-kind lottery (MKL) model calculated the expected distribution of Plasmodium infections in the population and compared it to observed values using a chi-squared test (χ2).

Results: The Plasmodium prevalence was 25.9% (2521/9724) by microscopy and 51.1% (4969/9724) by PCR. Among all infections detected by PCR, Pf, P. malariae (Pm), and P. ovale (Po) mono-infections were 58.6%, 3.1%, and 1.8%, respectively. Pf/Pm, Pf/Po, Pm/Po, and Pf/Pm/Po co-infections were 23.5%, 4.3%, 0.1%, and 8.6%, respectively. MKL modelling revealed non-random distributions, with frequencies of Pf/Pm and Pf/Pm/Po co-infections being significantly higher than expected (χ2 = 3385.60, p < 0.001). Pf co-infections with Pm and Po were associated with a decreased risk of fever (aOR 0.64, 95% CI 0.46-0.83; p = 0.01) and increased risks of splenomegaly (aOR 12.79, 95% CI 9.69-16.9; p < 0.001) and anaemia (aOR 2.57, 95% CI 2.09-3.15; p < 0.001), compared to single-species infections.

Conclusion: This study sheds light on the potential interaction between Pf and Pm and/or Po. Given the clinical significance of mixed-species infections, improved diagnostics, and case management of Pm and Po are urgently needed.

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2012-2018年肯尼亚维多利亚湖地区儿童疟原虫感染的非随机分布及相关临床特征。
背景:虽然恶性疟原虫(Pf)是人类最致命的疟疾寄生虫,但也不应忽视其他种类寄生虫的影响。此外,人们对混合疟原虫感染及其临床影响明显缺乏了解:我们于 2012 年 1 月至 2 月和 2018 年 9 月至 10 月期间在肯尼亚西部维多利亚湖地区进行了八次基于学校的横断面疟疾测量调查。在每次调查中,我们从大陆 Ungoye 村的一所学校和 Mfangano 岛上每个集水区的每所学校中随机抽取了至少 100 名 3 至 15 岁的儿童。疟原虫感染情况通过显微镜和巢式聚合酶链反应(PCR)进行检测。多种类抽签(MKL)模型计算了人群中疟原虫感染的预期分布,并使用卡方检验(χ2)将其与观察值进行比较:显微镜检测的疟原虫感染率为 25.9%(2521/9724),PCR 检测的疟原虫感染率为 51.1%(4969/9724)。在 PCR 检测到的所有感染中,疟原虫、疟疾疟原虫(Pm)和卵形疟原虫(Po)单一感染分别占 58.6%、3.1% 和 1.8%。Pf/Pm、Pf/Po、Pm/Po 和 Pf/Pm/Po 合并感染的比例分别为 23.5%、4.3%、0.1% 和 8.6%。本研究揭示了 Pf 与 Pm 和/或 Po 之间潜在的相互作用。鉴于混合物种感染的临床意义,迫切需要改进 Pm 和 Po 的诊断和病例管理。
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来源期刊
Tropical Medicine and Health
Tropical Medicine and Health TROPICAL MEDICINE-
CiteScore
7.00
自引率
2.20%
发文量
90
审稿时长
11 weeks
期刊最新文献
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