期刊
AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE
卷 88, 期 4, 页码 736-743出版社
AMER SOC TROP MED & HYGIENE
DOI: 10.4269/ajtmh.12-0654
关键词
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资金
- US President's Emergency Plan for AIDS Relief from Centers for Disease Control and Prevention (CDC) [U62P024421]
- National Center for HIV, Viral Hepatitis, STD, and TB Prevention (NCHHSTP)
- Global AIDS Program (GAP)
- National Institutes of Health [2 T32 AI 60530-6]
- Burroughs Wellcome Fund/American Society of Tropical Medicine and Hygiene Postdoctoral Fellowship
- Doris Duke Charitable Foundation
Artemisinin-based combination therapies (ACTs) and trimethoprim-sulfamethoxazole (TS) prophylaxis are important tools for malaria control, but there are concerns about their effect on gametocytes, the stage of the parasite responsible for transmission. We conducted a longitudinal clinical trial in a cohort of HIV-infected and uninfected children living in an area of high malaria transmission intensity in Uganda. Study participants were randomized to artemether-lumefantrine (AL) or dihydroartemisinin-piperaquine (DP) for all treatments of uncomplicated malaria (N = 4,380) as well as TS prophylaxis for different durations. The risks of gametocytemia detected by microscopy in the 28 days after antimalarial therapy were compared using multivariate analyses. The risk of gametocyte detection was significantly higher in patients treated with DP compared with AL (adjusted relative risk = 1.85, P < 0.001) and among children prescribed TS prophylaxis (adjusted relative risk = 1.76, P < 0.001). The risk of gametocytemia and its potential for increasing transmission should be considered when evaluating different ACTs and TS prophylaxis for malaria control.
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