Author(s):
Garcia Castillo, Stefano S. ; Abanto Alvarez, Caroline ; Rosas-Aguirre, Ángel ; Acosta, Carlos ; Corder, Rodrigo M. ; Gómez, Joaquín ; Guzmán, Mitchel ; Speybroeck, Niko ; Llanos-Cuentas, Alejandro ; Castro, Marcia C. ; Rosanas-Urgell, Anna ; Ferreira, Marcelo U. ; Vinetz, Joseph M. ; Gamboa, Dionicia ; Torres, Katherine
Date: 2024
Persistent ID: http://hdl.handle.net/10362/175539
Origin: Repositório Institucional da UNL
Subject(s): Public Health, Environmental and Occupational Health; Infectious Diseases; SDG 3 - Good Health and Well-being
Description
Funding agency: International Center of Excellence in Malaria Research (ICEMR). US Public Health Service, National Institutes of Health/National Institute of Allergy and Infectious Diseases (NIH/NIAID), USA (U19AI089681). Fogarty Training Grant (NIH-USA) (2D43TW007120-11A).
BACKGROUND: In the Peruvian Amazon, Plasmodium vivax malaria transmission is maintained due to the high frequency of recurrences. By understanding the recurrence rates of submicroscopic and asymptomatic cases, we can develop informed strategies to prevent transmission more efficiently and disrupt the silent transmission cycle. METHODS: A three-year, population-based cohort study was conducted in two sites, Cahuide and Lupuna, within the Loreto region in Peru from 2013 to 2015. The study included 385 individuals and aimed to examine the temporal dynamics of malaria recurrences and their impact on transmission and control. RESULTS: Individuals from Lupuna presented a higher risk of P. vivax infections compared to Cahuide, where most recurrences were asymptomatic and submicroscopic. It is estimated that a great proportion of these recurrences were due to relapses in both communities. The application of molecular diagnostic method proved to be significantly more effective, detecting 2.3 times more episodes during the follow-up (PCR, 1068; microscopy, 467). PCR identified recurrences significantly earlier, at 151 days after an initial infection, compared to microscopy, which detected them on average after 365 days. Community, occupation and previous malaria infections were factors associated with recurrences. Finally, potential infection evolution scenarios were described where one frequent scenario involved the transition from symptomatic to asymptomatic infections with a mean evolution time of 240 days. CONCLUSIONS: This study explores the contrast in malaria recurrence risk among individuals from two endemic settings, a consequence of prolonged exposure to the parasite. Through the analysis of the evolution scenarios of P. vivax recurrences, it is possible to have a more complete vision of how the transmission pattern changes over time and is conditioned by different factors.
