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Differential impact of malaria control interventions on P. falciparum and P. vivax infections in young Papua New Guinean children

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Show simple item record Ome-Kaius, M. en_US Kattenberg, J. H. en_US Zaloumis, S. en_US Siba, M. en_US Kiniboro, B. en_US Jally, S. en_US Razook, Z. en_US Mantila, D. en_US Sui, D. en_US Ginny, J. en_US Rosanas-Urgell, A. en_US Karl, S. en_US Obadia, T. en_US Barry, A. en_US Rogerson, S. J. en_US Laman, M. en_US Tisch, D. en_US Felger, I. en_US Kazura, J. W. en_US Mueller, I. en_US Robinson, L. J. en_US 2020-08-25T09:38:35Z 2020-08-25T09:38:35Z 2019 en_US
dc.identifier.issn 1741-7015 en_US
dc.identifier.doi en_US
dc.identifier.other ITG-B2A; ITG-B11A; DBM; U-MALAR; JIF; DOI; CPDF; PMC; Abstract; ITMPUB; DSPACE68 en_US
dc.description.abstract INTRODUCTION: As malaria transmission declines, understanding the differential impact of intensified control on Plasmodium falciparum relative to Plasmodium vivax and identifying key drivers of ongoing transmission is essential to guide future interventions. METHODS: Three longitudinal child cohorts were conducted in Papua New Guinea before (2006/2007), during (2008) and after scale-up of control interventions (2013). In each cohort, children aged 1-5 years were actively monitored for infection and illness. Incidence of malaria episodes, molecular force of blood-stage infections (molFOB) and population-averaged prevalence of infections were compared across the cohorts to investigate the impact of intensified control in young children and the key risk factors for malaria infection and illness in 2013. RESULTS: Between 2006 and 2008, P. falciparum infection prevalence, molFOB, and clinical malaria episodes reduced by 47%, 59% and 69%, respectively, and a further 49%, 29% and 75% from 2008 to 2013 (prevalence 41.6% to 22.1% to 11.2%; molFOB: 3.4 to 1.4 to 1.0 clones/child/year; clinical episodes incidence rate (IR) 2.6 to 0.8 to IR 0.2 episodes/child/year). P. vivax clinical episodes declined at rates comparable to P. falciparum between 2006, 2008 and 2013 (IR 2.5 to 1.1 to 0.2), while P. vivax molFOB (2006, 9.8; 2008, 12.1) and prevalence (2006, 59.6%; 2008, 65.0%) remained high in 2008. However, in 2013, P. vivax molFOB (1.2) and prevalence (19.7%) had also substantially declined. In 2013, 89% of P. falciparum and 93% of P. vivax infections were asymptomatic, 62% and 47%, respectively, were sub-microscopic. Area of residence was the major determinant of malaria infection and illness. CONCLUSION: Intensified vector control and routine case management had a differential impact on rates of P. falciparum and P. vivax infections but not clinical malaria episodes in young children. This suggests comparable reductions in new mosquito-derived infections but a delayed impact on P. vivax relapsing infections due to a previously acquired reservoir of hypnozoites. This demonstrates the need to strengthen implementation of P. vivax radical cure to maximise impact of control in co-endemic areas. The high heterogeneity of malaria in 2013 highlights the importance of surveillance and targeted interventions to accelerate towards elimination. en_US
dc.language English en_US
dc.relation.uri en_US
dc.subject Malaria en_US
dc.subject Protozoal diseases en_US
dc.subject Plasmodium falciparum en_US
dc.subject Plasmodium vivax en_US
dc.subject Control en_US
dc.subject Children en_US
dc.subject Papua New Guinea en_US
dc.subject Oceania en_US
dc.title Differential impact of malaria control interventions on P. falciparum and P. vivax infections in young Papua New Guinean children en_US
dc.type Article-E en_US
dc.citation.issue 1 en_US
dc.citation.jtitle BMC Medicine en_US
dc.citation.volume 17 en_US
dc.citation.pages 220 en_US
dc.citation.abbreviation BMC Med en_US

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