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首页> 外文期刊>The American Journal of Tropical Medicine and Hygiene >Evidence for Reduced Malaria Parasite Population after Application of Population-Level Antimalarial Drug Strategies in Southern Province, Zambia
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Evidence for Reduced Malaria Parasite Population after Application of Population-Level Antimalarial Drug Strategies in Southern Province, Zambia

机译：在赞比亚南部省份人口水平抗疟药策略后减少疟疾寄生虫人群的证据

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A mass drug administration trial was carried out in Southern Province, Zambia, between 2014 and 2016, in conjunction with a standard of care package that included improved surveillance, increased access to malaria case management, and sustained high levels of vector control coverage. This was preceded by mass test and treatment in the same area from 2011 to 2013. Concordant decreases in malaria prevalence in Southern Province and deaths attributed to malaria in Zambia over this time suggest that these strategies successfully reduced the malaria burden. Genetic epidemiological studies were used to assess the consequences of these interventions on parasite population structure. Analysis of parasite material derived from 1,620 rapid diagnostic test (RDT)-positive individuals obtained from studies to evaluate trial outcomes revealed a reduction in the average complexity of infection and consequential increase in the proportion of infections that harbored a single parasite genome (monogenomic infections). Highly related parasites, consistent with inbreeding, were detected after interventions were deployed. Geographical analysis indicated that the highly related infections were both clustered focally and dispersed across the study area. These findings provide genetic evidence for a reduced parasite population, with indications of inbreeding following the application of comprehensive interventions, including drug-based campaigns, that reduced the malaria burden in Southern Province. Genetic data additionally revealed the relationship between individual infections in the context of these population-level patterns, which has the potential to provide useful data for stratification and targeting of interventions to reduce the malaria burden.
机译：大规模药物管理局试验在南部省，赞比亚进行，2014年至2016年间，配合了一揽子护理包装，包括改进监测，增加对疟疾案例管理的获得，以及持续高水平的矢量控制覆盖范围。从2011年至2013年的同一地区的质量试验和治疗方法在同一地区之前。南部省疟疾的一致性降低了，据满意西亚的疟疾疫情归因于赞比亚的疟疾表明这些策略成功地减少了疟疾负担。遗传流行病学研究用于评估这些干扰对寄生虫种群结构的后果。从研究中获得的1,620次快速诊断试验（RDT） - 阳性个体的寄生虫材料分析，以评估试验结果显示感染的平均复杂性的降低以及患有单个寄生虫基因组的感染比例的相应增加（单因子感染） 。在部署干预后，检测到具有近亲繁殖的高度相关寄生虫。地理分析表明，高度相关的感染均伴随着聚集在一起并分散在研究区域。这些调查结果为降低的寄生虫人群提供了遗传证据，在综合干预措施（包括毒品的竞选活动）上，近亲繁殖的迹象表明，减少了南部省疟疾的疟疾负担。遗传数据另外揭示了这些人口水平模式的上下文中个体感染之间的关系，这有可能为减少疟疾负担的分层和靶向提供有用的数据。

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