Primaquine Clears Submicroscopic Plasmodium falciparum Gametocytes that Persist after Treatment with Sulphadoxine-Pyrimethamine and Artesunate 英文参考文献.docVIP

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Primaquine Clears Submicroscopic Plasmodium falciparum Gametocytes that Persist after Treatment with Sulphadoxine-Pyrimethamine and Artesunate 英文参考文献.doc

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Primaquine Clears Submicroscopic Plasmodium falciparum Gametocytes that Persist after Treatment with Sulphadoxine-Pyrimethamine and Artesunate 英文参考文献

PrimaquineClearsSubmicroscopicPlasmodium falciparumGametocytesthatPersistafterTreatment withSulphadoxine-PyrimethamineandArtesunate SeifShekalaghe1,2,ChrisDrakeley3,4,RolyGosling3,4,ArnoldNdaro2,MoniquevanMeegeren1,AndersEnevold4,5,MichaelAlifrangis4,5 ,Frank Mosha2,4,RobertSauerwein1,TeunBousema1* 1Department ofMedicalMicrobiology,RadboudUniversityNijmegenMedicalCentre,Nijmegen,TheNetherlands,2KilimanjaroChristianMedical Centre, Moshi, Tanzania, 3Department of Infectious and Tropical Disease, London School of Hygiene and Tropical Medicine, London, United Kingdom,4JointMalariaProgramme,KilimanjaroChristianMedicalCentre(KCMC),Moshi,Tanzania,5InstituteforInternationalHealth,Immunology andMicrobiology,CenterforMedicalParasitology(CMP),UniversityofCopenhagen,Copenhagen,Denmark Background.P.falciparumgametocytesmaypersistaftertreatmentwithsulphadoxine-pyrimethamine(SP)plusartesunate (AS) and contribute considerably to malaria transmission. We determined the efficacy of SP+AS plus a single dose of primaquine (PQ, 0.75mg/kg) on clearing gametocytaemia measured by molecular methods. Methodology. The study was conducted in Mnyuzi, an area of hyperendemic malaria in north-eastern Tanzania. Children aged 3–15years with uncomplicated P. falciparum malaria with an asexual parasite density between 500–100,000 parasites/mL were randomized to receive treatment with either SP+AS or SP+AS+PQ. P. falciparum gametocyte prevalence and density during the 42-day follow-up period were determined by real-time nucleic acid sequence-based amplification (QT-NASBA). Haemoglobin levels (Hb) were determined to address concerns about haemolysis in G6PD-deficient individuals. Results. 108 individuals were randomized.Pfs25QT-NASBAgametocyteprevalencewas88–91%atenrolmentanddecreasedafterwardsforbothtreatment arms. Gametocyte prevalence and density were significantly lower in children treated with SP+AS+PQ. On day 14 after treatment3.9%(2/51)oftheSP+AS+PQtreatedchildrenharbouredgametocytescompared