Differential Patterns of Infection and Disease with P. falciparum and P. vivax in Young Papua New Guinean Children 英文参考文献.docVIP

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Differential Patterns of Infection and Disease with P. falciparum and P. vivax in Young Papua New Guinean Children 英文参考文献.doc

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Differential Patterns of Infection and Disease with P. falciparum and P. vivax in Young Papua New Guinean Children 英文参考文献

DifferentialPatternsofInfectionandDiseasewithP. falciparumandP.vivaxinYoungPapuaNewGuinean Children EnmooreLin1,BensonKiniboro1,LaurieGray2,StuartDobbie1,LeanneRobinson3,4 ,Annemarie Laumaea1,SonjaScho¨pflin5,DanielleStanisic1,3,InoniBetuela1,MelindaBlood-Zikursh2,PeterSiba1, IngridFelger5,LouisSchofield3,PeterZimmerman2,IvoMueller1* 1PNGInstituteofMedicalResearch,Madang,PapuaNewGuinea,2CentreforGlobalHealthDisease,CaseWesternReserveUniversity,Cleveland,Ohio,UnitedStatesof America, 3Walter Eliza Hall Institute, Parkville, Victoria, Australia, 4Department of Medical Biology, University of Melbourne, Melbourne, Victoria, Australia, 5Swiss TropicalInstitute,Basel,Switzerland Abstract Background: Where P. vivax and P. falciparum occur in the same population, the peak burden of P. vivax infection and illnessisoftenconcentratedinyoungeragegroups.Experiencesfrommalariatherapypatientsindicatethatimmunityis acquiredfastertoP.vivaxthantoP.falciparumchallenge.Thereishoweverlittleprospectivedataonthecomparativeriskof infectionanddiseasefrombothspeciesinyoungchildrenlivinginco-endemicareas. Methodology/PrincipalFindings:Acohortof264PapuaNewGuineanchildrenaged1-3years(atenrolment)wereactively followed-upforPlasmodiuminfectionandfebrileillnessfor16months.Infectionstatuswasdeterminedbylightmicroscopy andPCRevery8weeksandateachfebrileepisode.Ageneralisedestimatingequation(GEE)approachwasusedtoanalyse both prevalence of infection and incidence of clinical episodes. A more pronounced rise in prevalence of P. falciparum compared to P. vivax infection was evident with increasing age. Although the overall incidence of clinical episodes was comparable(P.falciparum:2.56,P.vivax2.46episodes/child/yr),P.falciparumandP.vivaxinfectiousepisodesshowed strongbutopposingagetrends:P.falciparumincidenceincreaseduntiltheageof30monthswithlittlechangethereafter, but incidence of P. vivax decreased significantly with age throughout the entire age range. For P. falciparum , both prevalenceandincidence