RISK FACTORS FOR PLASMODIUM VIVAX GAMETOCYTE CARRIAGE IN THAILAND

MATHIEU NACHER Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Shoklo Malaria Research Unit, Mae Sot, Tak, Thailand; Unité d’Epidémiologie des Maladies Emergentes, Institut Pasteur, Paris, France

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UDOMSAK SILACHAMROON Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Shoklo Malaria Research Unit, Mae Sot, Tak, Thailand; Unité d’Epidémiologie des Maladies Emergentes, Institut Pasteur, Paris, France

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PRATAP SINGHASIVANON Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Shoklo Malaria Research Unit, Mae Sot, Tak, Thailand; Unité d’Epidémiologie des Maladies Emergentes, Institut Pasteur, Paris, France

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POLRAT WILAIRATANA Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Shoklo Malaria Research Unit, Mae Sot, Tak, Thailand; Unité d’Epidémiologie des Maladies Emergentes, Institut Pasteur, Paris, France

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WEERAPONG PHUMRATANAPRAPIN Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Shoklo Malaria Research Unit, Mae Sot, Tak, Thailand; Unité d’Epidémiologie des Maladies Emergentes, Institut Pasteur, Paris, France

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ARNAUD FONTANET Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Shoklo Malaria Research Unit, Mae Sot, Tak, Thailand; Unité d’Epidémiologie des Maladies Emergentes, Institut Pasteur, Paris, France

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SORNCHAI LOOAREESUWAN Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Shoklo Malaria Research Unit, Mae Sot, Tak, Thailand; Unité d’Epidémiologie des Maladies Emergentes, Institut Pasteur, Paris, France

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To study the risk factors for Plasmodium vivax gametocyte carriage, the presence or absence of gametocytes was determined in 2,125 patients with P. vivax malaria participating in clinical trials at the Hospital for Tropical Diseases in Bangkok, Thailand. Stepwise logistic regression models were used to determine which variables were significantly related to gametocyte carriage. On admission, 615 patients (29%) had detectable gametocytes (before treatment). After treatment had started, an additional 245 patients (11%) developed patent gametocytemia. The variables retained by multivariate analysis were highest observed temperature (adjusted odds ratio [AOR] per °C increase = 0.82, 95% confidence interval [CI] = 0.71–0.94, P = 0.006), asexual parasitemia > 9,200/μL (AOR = 2.8, 95% CI = 1.9–4.2, P < 0.0001), erythrocyte counts (AOR = 0.8/million/μL increase, 95% CI = 0.67–0.95, P = 0.01), monocyte percentage (AOR = 0.93 per % increase, 95% CI = 0.89–0.96, P < 0.0001), lymphocyte percentage (AOR = 0.98 per % increase, 95% CI = 0.97–0.99, P = 0.006), albumin (AOR = 0.67 per 10 g/mL increase, 95% CI = 0.5–0.9, P = 0.007), and anion gap (AOR = 1.1 per unit increase, 95% CI = 1.02–1.14, P = 0.009). The possible significance of these observations is discussed.

Author Notes

  • 1

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  • 2

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  • 3

    Nacher M, Singhasivanon P, Silachamroon U, Treeprasertsuk S, Tosukhowong T, Vannaphan S, Gay F, Mazier D, Looareesuwan S, 2002. Decreased hemoglobin concentrations, hyperparasitemia, and severe malaria are associated with increased Plasmodium falciparum gametocyte carriage. J Parasitol 88 :97–101.

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  • 4

    von Seidlein L, Drakeley C, Greenwood B, Walraven G, Targett G, 2001. Risk factors for gametocyte carriage in Gambian children. Am J Trop Med Hyg 65 :523–527.

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  • 5

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    Boyd MF, Stratman-Thomas WK, Muench H, 1935. The occurence of gametocytes of Plasmodium vivax during the primary attack. Am J Trop Med 16 :133–138.

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