- INTRODUCTION
- MATERIALS AND METHODS
- RESULTS
- Demographics of the study population.
- Active surveillance for malaria and anemia in the communities.
- Prevalence of anemia.
- Passive surveillance for symptomatic malaria.
- Passive versus active symptomatic case rates.
- Analysis of overall study population.
- Demographic associations and presentation of signs and symptoms.
- DISCUSSION
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1
Aramburu Guarda J, Ramal Asayag C, Witzig R, 1999. Malaria reemergence in the Peruvian Amazon region. Emerg Infect Dis 5 :209–215.
-
2
Roper MH, Carrion Torres RS, Cava Goicochea CG, Andersen EM, Aramburu Guarda JS, Calampa C, Hightower AW, Magill AJ, 2000. The epidemiology of malaria in an epidemic area of the Peruvian Amazon. Am J Trop Med Hyg 62 :247–256.
-
3
Alecrim MdG, Alecrim W, Macedo V, 1999. Plasmodium vivax resistance to chloroquine (R2) and mefloquine (R3) in Brazilian Amazon region. Rev Soc Bras Med Trop 32 :67–68.
-
4
Alecrim Mdos G, Alecrim WD, Macedo V, Korves CT, Roberts DR, Li J, Sullivan M, McCutchan TF, 1999. Description of a possible clonal expansion of Plasmodium vivax in Manaus-Amazonas-Brazil. Rev Soc Bras Med Trop 32 :303–305.
-
5
Guerin PJ, Olliaro P, Nosten F, Druilhe P, Laxminarayan R, Binka F, Kilama WL, Ford N, White NJ, 2002. Malaria: current status of control, diagnosis, treatment, and a proposed agenda for research and development. Lancet Infect Dis 2 :564–573.
-
6
Ministerio de Salud, Dirección Regional de Salud de Loreto, 1998. Boletín de Malaria 1997–1998. Iquitos, Peru.
-
7
Johnson JB, 1993. The Harriet Lane Handbook. St. Louis: Mosby-Year Book, Inc.
-
8
Snounou G, Viriyakosol S, Jarra W, Thaithong S, Brown KN, 1993. Identification of the four human malaria parasite species in field samples y the polymerase chain reaction and detection of a high prevalence of mixed infections. Mol Biochem Parasitol 58 :283–292.
-
9
Li J, Wirtz RA, McConkey GA, Sattabongkot J, Waters AP, Rogers MJ, McCutchan TF, 1995. Plasmodium: genus-conserved primers for species identification and quantitation. Exp Parasitol 81 :182–190.
-
10
Qari SH, Collins WE, Lobel HO, Taylor F, Lal AA, 1994. A study of polymorphism in the circumsporozoite protein of human malaria parasites. Am J Trop Med Hyg 50 :45–51.
-
11
McCutchan TF, de la Cruz VF, Lal AA, Gunderson JH, Elwood HJ, Sogin ML, 1988. Primary sequences of two small subunit ribosomal RNA genes from Plasmodium falciparum.Mol Biochem Parasitol 28 :63–68.
-
12
Checkley W, Gilman RH, Epstein LD, Suarez M, Diaz JF, Cabrera L, Black RE, Sterling CR, 1997. Asymptomatic and symptomatic cryptosporidiosis: their acute effect on weight gain in Peruvian children. Am J Epidemiol 145 :156–163.
-
13
Bottius E, Guanzirolli A, Trape J-F, Rogier C, Konate L, Druilhe P, 1996. Malaria: even more chronic in nature than previously thought; evidence for subpatent parasitaemia detectable by the polymerase chain reaction. Trans R Soc Trop Med Hyg 90 :15–19.
-
14
Alves FP, Durlacher RR, Menezes MJ, Krieger H, Silva LH, Camargo EP, 2002. High prevalence of asymptomatic Plasmodium vivax and Plasmodium falciparum infections in native Amazonian populations. Am J Trop Med Hyg 66 :641–648.
-
15
Vinetz JM, Gilman RH, 2002. Asymptomatic Plasmodium parasitemia and the ecology of malaria transmission. Am J Trop Med Hyg 66 :639–640.
-
16
Baird JK, Jones TR, Danudirgo EW, Annis BA, Bangs MJ, Basri H, Purnomo, Masbar S, 1991. Age-dependent acquired protection against Plasmodium falciparum in people having two years exposure to hyperendemic malaria. Am J Trop Med Hyg 45 :65–76.
-
17
Fryauff D, Tuti S, Mardi A, Masbar S, Patipelohi R, Leksana B, Kain K, Bangs M, Richie T, Baird J, 1998. Chloroquine-resistant Plasmodium vivax in transmigration settlements of West Kalimantan, Indonesia. Am J Trop Med Hyg 59 :513–518.
-
18
Laserson KF, Wypij D, Petralanda I, Spielman A, Maguire JH, 1999. Differential perpetuation of malaria species among Amazonian Yanomami Amerindians. Am J Trop Med Hyg 60 :767–773.
-
19
Snounou G, Viriyakosol S, Zhu XP, Jarra W, Pinheiro L, do Rosario VE, Thaithong S, Brown KN, 1993. High sensitivity of detection of human malaria parasites by the use of nested polymerase chain reaction. Mol Biochem Parasitol 61 :315–320.
-
20
Craig MH, Bredenkamp BL, Williams CH, Rossouw EJ, Kelly VJ, Kleinschmidt I, Martineau A, Henry GF, 2002. Field and laboratory comparative evaluation of ten rapid malaria diagnostic tests. Trans R Soc Trop Med Hyg 96 :258–265.
-
21
Owusu-Agyei S, Smith T, Beck HP, Amenga-Etego L, Felger I, 2002. Molecular epidemiology of Plasmodium falciparum infections among asymptomatic inhabitants of a holoendemic malarious area in northern Ghana. Trop Med Int Health 7 :421–428.
-
22
Brown AE, Kain KC, Pipithkul J, Webster HK, 1992. Demonstration by the polymerase chain reaction of mixed Plasmodium falciparum and P. vivax infections undetected by conventional microscopy. Trans R Soc Trop Med Hyg 86 :609–612.
-
23
Tham JM, Lee SH, Tan TM, Ting RC, Kara UA, 1999. Detection and species determination of malaria parasites by PCR: comparison with microscopy and with ParaSight-F and ICT malaria Pf tests in a clinical environment. J Clin Microbiol 37 :1269–1273.
-
24
Urdaneta L, Guevara P, Ramirez JL, 1998. Evaluation of DNA recombinant methodologies for the diagnosis of Plasmodium falciparum and their comparison with the microscopy assay. Mem Inst Oswaldo Cruz 93 :639–646.
-
25
Cavasini MT, Ribeiro WL, Kawamoto F, Ferreira MU, 2000. How prevalent is Plasmodium malariae in Rondonia, western Brazilian Amazon? Rev Soc Bras Med Trop 33 :489–492.
-
26
Woodruff AW, Ansdell VE, Pettitt LE, 1979. Cause of anaemia in malaria. Lancet 1 :1055–1057.
-
27
Ekvall H, Premji Z, Bennett S, Bjorkman A, 2001. Hemoglobin concentration in children in a malaria holoendemic area is determined by cumulated Plasmodium falciparum parasite densities. Am J Trop Med Hyg 64 :58–66.
-
28
Kurtzhals JA, Addae MM, Akanmori BD, Dunyo S, Koram KA, Appawu MA, Nkrumah FK, Hviid L, 1999. Anaemia caused by asymptomatic Plasmodium falciparum infection in semi-immune African schoolchildren. Trans R Soc Trop Med Hyg 93 :623–627.
-
29
Kurtzhals JA, Rodrigues O, Addae M, Commey JO, Nkrumah FK, Hviid L, 1997. Reversible suppression of bone marrow response to erythropoietin in Plasmodium falciparum malaria. Br J Haematol 97 :169–174.
-
30
Owusu-Agyei S, Binka F, Koram K, Anto F, Adjuik M, Nkrumah F, Smith T, 2002. Does radical cure of asymptomatic Plasmodium falciparum place adults in endemic areas at increased risk of recurrent symptomatic malaria? Trop Med Int Health 7 :599–603.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 2187 | 2051 | 45 |
| Full Text Views | 406 | 14 | 1 |
| PDF Downloads | 126 | 15 | 1 |
ENDEMIC MALARIA IN THE PERUVIAN AMAZON REGION OF IQUITOS
BABACK ROSHANRAVAN
BABACK ROSHANRAVAN
Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana; Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland; Universidad Peruana Cayetano Heredia, Lima, Peru; Ochsner Clinic Foundation, New Orleans, Louisiana; Proyectos en Informática Salud, Medicina y Agricultura (Asociación Benéfica PRISMA), Lima, Peru; Dirección Regional de Salud de Loreto, Iquitos, Peru; World Health Organization Collaborating Center for Tropical Diseases, University of Texas Medical Branch, Galveston, Texas
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ELINA KARI
ELINA KARI
Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana; Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland; Universidad Peruana Cayetano Heredia, Lima, Peru; Ochsner Clinic Foundation, New Orleans, Louisiana; Proyectos en Informática Salud, Medicina y Agricultura (Asociación Benéfica PRISMA), Lima, Peru; Dirección Regional de Salud de Loreto, Iquitos, Peru; World Health Organization Collaborating Center for Tropical Diseases, University of Texas Medical Branch, Galveston, Texas
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ROBERT H. GILMAN
ROBERT H. GILMAN
Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana; Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland; Universidad Peruana Cayetano Heredia, Lima, Peru; Ochsner Clinic Foundation, New Orleans, Louisiana; Proyectos en Informática Salud, Medicina y Agricultura (Asociación Benéfica PRISMA), Lima, Peru; Dirección Regional de Salud de Loreto, Iquitos, Peru; World Health Organization Collaborating Center for Tropical Diseases, University of Texas Medical Branch, Galveston, Texas
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LILIA CABRERA
LILIA CABRERA
Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana; Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland; Universidad Peruana Cayetano Heredia, Lima, Peru; Ochsner Clinic Foundation, New Orleans, Louisiana; Proyectos en Informática Salud, Medicina y Agricultura (Asociación Benéfica PRISMA), Lima, Peru; Dirección Regional de Salud de Loreto, Iquitos, Peru; World Health Organization Collaborating Center for Tropical Diseases, University of Texas Medical Branch, Galveston, Texas
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ELLEN LEE
ELLEN LEE
Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana; Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland; Universidad Peruana Cayetano Heredia, Lima, Peru; Ochsner Clinic Foundation, New Orleans, Louisiana; Proyectos en Informática Salud, Medicina y Agricultura (Asociación Benéfica PRISMA), Lima, Peru; Dirección Regional de Salud de Loreto, Iquitos, Peru; World Health Organization Collaborating Center for Tropical Diseases, University of Texas Medical Branch, Galveston, Texas
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JOHN METCALFE
JOHN METCALFE
Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana; Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland; Universidad Peruana Cayetano Heredia, Lima, Peru; Ochsner Clinic Foundation, New Orleans, Louisiana; Proyectos en Informática Salud, Medicina y Agricultura (Asociación Benéfica PRISMA), Lima, Peru; Dirección Regional de Salud de Loreto, Iquitos, Peru; World Health Organization Collaborating Center for Tropical Diseases, University of Texas Medical Branch, Galveston, Texas
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MARITZA CALDERON
MARITZA CALDERON
Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana; Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland; Universidad Peruana Cayetano Heredia, Lima, Peru; Ochsner Clinic Foundation, New Orleans, Louisiana; Proyectos en Informática Salud, Medicina y Agricultura (Asociación Benéfica PRISMA), Lima, Peru; Dirección Regional de Salud de Loreto, Iquitos, Peru; World Health Organization Collaborating Center for Tropical Diseases, University of Texas Medical Branch, Galveston, Texas
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ANDRES G. LESCANO
ANDRES G. LESCANO
Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana; Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland; Universidad Peruana Cayetano Heredia, Lima, Peru; Ochsner Clinic Foundation, New Orleans, Louisiana; Proyectos en Informática Salud, Medicina y Agricultura (Asociación Benéfica PRISMA), Lima, Peru; Dirección Regional de Salud de Loreto, Iquitos, Peru; World Health Organization Collaborating Center for Tropical Diseases, University of Texas Medical Branch, Galveston, Texas
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SONIA H. MONTENEGRO
SONIA H. MONTENEGRO
Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana; Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland; Universidad Peruana Cayetano Heredia, Lima, Peru; Ochsner Clinic Foundation, New Orleans, Louisiana; Proyectos en Informática Salud, Medicina y Agricultura (Asociación Benéfica PRISMA), Lima, Peru; Dirección Regional de Salud de Loreto, Iquitos, Peru; World Health Organization Collaborating Center for Tropical Diseases, University of Texas Medical Branch, Galveston, Texas
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CARLOS CALAMPA
CARLOS CALAMPA
Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana; Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland; Universidad Peruana Cayetano Heredia, Lima, Peru; Ochsner Clinic Foundation, New Orleans, Louisiana; Proyectos en Informática Salud, Medicina y Agricultura (Asociación Benéfica PRISMA), Lima, Peru; Dirección Regional de Salud de Loreto, Iquitos, Peru; World Health Organization Collaborating Center for Tropical Diseases, University of Texas Medical Branch, Galveston, Texas
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JOSEPH M. VINETZ
JOSEPH M. VINETZ
Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana; Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland; Universidad Peruana Cayetano Heredia, Lima, Peru; Ochsner Clinic Foundation, New Orleans, Louisiana; Proyectos en Informática Salud, Medicina y Agricultura (Asociación Benéfica PRISMA), Lima, Peru; Dirección Regional de Salud de Loreto, Iquitos, Peru; World Health Organization Collaborating Center for Tropical Diseases, University of Texas Medical Branch, Galveston, Texas
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A cross-sectional study was conducted in the Peruvian Amazon to test the hypothesis that a reservoir of asymptomatic malaria parasitemic patients would form the basis for continuing malaria endemicity in the region. Active surveillance yielded a Plasmodium spp. slide-positive prevalence of 4.2% (43 of 1,023) and a polymerase chain reaction (PCR)–positive prevalence of 17.6% (144 of 819). Plasmodium vivax prevalence was 2.9% and 14.2% while Plasmodium falciparum prevalence was 1.3% and 2.6% by microscopy and PCR, respectively. Approximately two-thirds of slide-positive and one-fourth of PCR-positive people were symptomatic. Anemia was associated with slide positivity (P < 0.001) and PCR positivity for P. falciparum (P = 0.003). Sensitivity of field microscopy and agreement between field and reference laboratory microscopists were low, arguing for using PCR for epidemiologic investigation and malaria control. While these data confirm recent findings from the Brazilian Amazon suggesting that sufficient numbers of asymptomatic malaria parasitemic patients are present to form a persistent reservoir for continuous reinfection within the Peruvian Amazon region, these results also indicate that clinical immunity in human populations can be driven in malaria-endemic regions that do not have high intensity malaria transmission
Author Notes
- INTRODUCTION
- MATERIALS AND METHODS
- RESULTS
- Demographics of the study population.
- Active surveillance for malaria and anemia in the communities.
- Prevalence of anemia.
- Passive surveillance for symptomatic malaria.
- Passive versus active symptomatic case rates.
- Analysis of overall study population.
- Demographic associations and presentation of signs and symptoms.
- DISCUSSION
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1
Aramburu Guarda J, Ramal Asayag C, Witzig R, 1999. Malaria reemergence in the Peruvian Amazon region. Emerg Infect Dis 5 :209–215.
-
2
Roper MH, Carrion Torres RS, Cava Goicochea CG, Andersen EM, Aramburu Guarda JS, Calampa C, Hightower AW, Magill AJ, 2000. The epidemiology of malaria in an epidemic area of the Peruvian Amazon. Am J Trop Med Hyg 62 :247–256.
-
3
Alecrim MdG, Alecrim W, Macedo V, 1999. Plasmodium vivax resistance to chloroquine (R2) and mefloquine (R3) in Brazilian Amazon region. Rev Soc Bras Med Trop 32 :67–68.
-
4
Alecrim Mdos G, Alecrim WD, Macedo V, Korves CT, Roberts DR, Li J, Sullivan M, McCutchan TF, 1999. Description of a possible clonal expansion of Plasmodium vivax in Manaus-Amazonas-Brazil. Rev Soc Bras Med Trop 32 :303–305.
-
5
Guerin PJ, Olliaro P, Nosten F, Druilhe P, Laxminarayan R, Binka F, Kilama WL, Ford N, White NJ, 2002. Malaria: current status of control, diagnosis, treatment, and a proposed agenda for research and development. Lancet Infect Dis 2 :564–573.
-
6
Ministerio de Salud, Dirección Regional de Salud de Loreto, 1998. Boletín de Malaria 1997–1998. Iquitos, Peru.
-
7
Johnson JB, 1993. The Harriet Lane Handbook. St. Louis: Mosby-Year Book, Inc.
-
8
Snounou G, Viriyakosol S, Jarra W, Thaithong S, Brown KN, 1993. Identification of the four human malaria parasite species in field samples y the polymerase chain reaction and detection of a high prevalence of mixed infections. Mol Biochem Parasitol 58 :283–292.
-
9
Li J, Wirtz RA, McConkey GA, Sattabongkot J, Waters AP, Rogers MJ, McCutchan TF, 1995. Plasmodium: genus-conserved primers for species identification and quantitation. Exp Parasitol 81 :182–190.
-
10
Qari SH, Collins WE, Lobel HO, Taylor F, Lal AA, 1994. A study of polymorphism in the circumsporozoite protein of human malaria parasites. Am J Trop Med Hyg 50 :45–51.
-
11
McCutchan TF, de la Cruz VF, Lal AA, Gunderson JH, Elwood HJ, Sogin ML, 1988. Primary sequences of two small subunit ribosomal RNA genes from Plasmodium falciparum.Mol Biochem Parasitol 28 :63–68.
-
12
Checkley W, Gilman RH, Epstein LD, Suarez M, Diaz JF, Cabrera L, Black RE, Sterling CR, 1997. Asymptomatic and symptomatic cryptosporidiosis: their acute effect on weight gain in Peruvian children. Am J Epidemiol 145 :156–163.
-
13
Bottius E, Guanzirolli A, Trape J-F, Rogier C, Konate L, Druilhe P, 1996. Malaria: even more chronic in nature than previously thought; evidence for subpatent parasitaemia detectable by the polymerase chain reaction. Trans R Soc Trop Med Hyg 90 :15–19.
-
14
Alves FP, Durlacher RR, Menezes MJ, Krieger H, Silva LH, Camargo EP, 2002. High prevalence of asymptomatic Plasmodium vivax and Plasmodium falciparum infections in native Amazonian populations. Am J Trop Med Hyg 66 :641–648.
-
15
Vinetz JM, Gilman RH, 2002. Asymptomatic Plasmodium parasitemia and the ecology of malaria transmission. Am J Trop Med Hyg 66 :639–640.
-
16
Baird JK, Jones TR, Danudirgo EW, Annis BA, Bangs MJ, Basri H, Purnomo, Masbar S, 1991. Age-dependent acquired protection against Plasmodium falciparum in people having two years exposure to hyperendemic malaria. Am J Trop Med Hyg 45 :65–76.
-
17
Fryauff D, Tuti S, Mardi A, Masbar S, Patipelohi R, Leksana B, Kain K, Bangs M, Richie T, Baird J, 1998. Chloroquine-resistant Plasmodium vivax in transmigration settlements of West Kalimantan, Indonesia. Am J Trop Med Hyg 59 :513–518.
-
18
Laserson KF, Wypij D, Petralanda I, Spielman A, Maguire JH, 1999. Differential perpetuation of malaria species among Amazonian Yanomami Amerindians. Am J Trop Med Hyg 60 :767–773.
-
19
Snounou G, Viriyakosol S, Zhu XP, Jarra W, Pinheiro L, do Rosario VE, Thaithong S, Brown KN, 1993. High sensitivity of detection of human malaria parasites by the use of nested polymerase chain reaction. Mol Biochem Parasitol 61 :315–320.
-
20
Craig MH, Bredenkamp BL, Williams CH, Rossouw EJ, Kelly VJ, Kleinschmidt I, Martineau A, Henry GF, 2002. Field and laboratory comparative evaluation of ten rapid malaria diagnostic tests. Trans R Soc Trop Med Hyg 96 :258–265.
-
21
Owusu-Agyei S, Smith T, Beck HP, Amenga-Etego L, Felger I, 2002. Molecular epidemiology of Plasmodium falciparum infections among asymptomatic inhabitants of a holoendemic malarious area in northern Ghana. Trop Med Int Health 7 :421–428.
-
22
Brown AE, Kain KC, Pipithkul J, Webster HK, 1992. Demonstration by the polymerase chain reaction of mixed Plasmodium falciparum and P. vivax infections undetected by conventional microscopy. Trans R Soc Trop Med Hyg 86 :609–612.
-
23
Tham JM, Lee SH, Tan TM, Ting RC, Kara UA, 1999. Detection and species determination of malaria parasites by PCR: comparison with microscopy and with ParaSight-F and ICT malaria Pf tests in a clinical environment. J Clin Microbiol 37 :1269–1273.
-
24
Urdaneta L, Guevara P, Ramirez JL, 1998. Evaluation of DNA recombinant methodologies for the diagnosis of Plasmodium falciparum and their comparison with the microscopy assay. Mem Inst Oswaldo Cruz 93 :639–646.
-
25
Cavasini MT, Ribeiro WL, Kawamoto F, Ferreira MU, 2000. How prevalent is Plasmodium malariae in Rondonia, western Brazilian Amazon? Rev Soc Bras Med Trop 33 :489–492.
-
26
Woodruff AW, Ansdell VE, Pettitt LE, 1979. Cause of anaemia in malaria. Lancet 1 :1055–1057.
-
27
Ekvall H, Premji Z, Bennett S, Bjorkman A, 2001. Hemoglobin concentration in children in a malaria holoendemic area is determined by cumulated Plasmodium falciparum parasite densities. Am J Trop Med Hyg 64 :58–66.
-
28
Kurtzhals JA, Addae MM, Akanmori BD, Dunyo S, Koram KA, Appawu MA, Nkrumah FK, Hviid L, 1999. Anaemia caused by asymptomatic Plasmodium falciparum infection in semi-immune African schoolchildren. Trans R Soc Trop Med Hyg 93 :623–627.
-
29
Kurtzhals JA, Rodrigues O, Addae M, Commey JO, Nkrumah FK, Hviid L, 1997. Reversible suppression of bone marrow response to erythropoietin in Plasmodium falciparum malaria. Br J Haematol 97 :169–174.
-
30
Owusu-Agyei S, Binka F, Koram K, Anto F, Adjuik M, Nkrumah F, Smith T, 2002. Does radical cure of asymptomatic Plasmodium falciparum place adults in endemic areas at increased risk of recurrent symptomatic malaria? Trop Med Int Health 7 :599–603.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 2187 | 2051 | 45 |
| Full Text Views | 406 | 14 | 1 |
| PDF Downloads | 126 | 15 | 1 |