Publication

Artemisinin-based combination therapy does not measurably reduce human infectiousness to vectors in a setting of intense malaria transmission

Huho, B. J., Killeen, G. F., Ferguson, H. M., Tami, A., Lengeler, C., Charlwood, J. D., Kihonda, A., Kihonda, J., Kachur, S. P., Smith, T. A. & Abdulla, S. M. K., 18-Apr-2012, In : Malaria journal. 11, 12 p., 118.

Research output: Contribution to journalArticleAcademicpeer-review

APA

Huho, B. J., Killeen, G. F., Ferguson, H. M., Tami, A., Lengeler, C., Charlwood, J. D., ... Abdulla, S. M. K. (2012). Artemisinin-based combination therapy does not measurably reduce human infectiousness to vectors in a setting of intense malaria transmission. Malaria journal, 11, [118]. https://doi.org/10.1186/1475-2875-11-118

Author

Huho, Bernadette J. ; Killeen, Gerard F. ; Ferguson, Heather M. ; Tami, Adriana ; Lengeler, Christian ; Charlwood, J. Derek ; Kihonda, Aniset ; Kihonda, Japhet ; Kachur, S. Patrick ; Smith, Thomas A. ; Abdulla, Salim M. K. / Artemisinin-based combination therapy does not measurably reduce human infectiousness to vectors in a setting of intense malaria transmission. In: Malaria journal. 2012 ; Vol. 11.

Harvard

Huho, BJ, Killeen, GF, Ferguson, HM, Tami, A, Lengeler, C, Charlwood, JD, Kihonda, A, Kihonda, J, Kachur, SP, Smith, TA & Abdulla, SMK 2012, 'Artemisinin-based combination therapy does not measurably reduce human infectiousness to vectors in a setting of intense malaria transmission', Malaria journal, vol. 11, 118. https://doi.org/10.1186/1475-2875-11-118

Standard

Artemisinin-based combination therapy does not measurably reduce human infectiousness to vectors in a setting of intense malaria transmission. / Huho, Bernadette J.; Killeen, Gerard F.; Ferguson, Heather M.; Tami, Adriana; Lengeler, Christian; Charlwood, J. Derek; Kihonda, Aniset; Kihonda, Japhet; Kachur, S. Patrick; Smith, Thomas A.; Abdulla, Salim M. K.

In: Malaria journal, Vol. 11, 118, 18.04.2012.

Research output: Contribution to journalArticleAcademicpeer-review

Vancouver

Huho BJ, Killeen GF, Ferguson HM, Tami A, Lengeler C, Charlwood JD et al. Artemisinin-based combination therapy does not measurably reduce human infectiousness to vectors in a setting of intense malaria transmission. Malaria journal. 2012 Apr 18;11. 118. https://doi.org/10.1186/1475-2875-11-118


BibTeX

@article{3e68e8f4199f41839f65cb48953d79ca,
title = "Artemisinin-based combination therapy does not measurably reduce human infectiousness to vectors in a setting of intense malaria transmission",
abstract = "Background: Artemisinin-based combination therapy (ACT) for treating malaria has activity against immature gametocytes. In theory, this property may complement the effect of terminating otherwise lengthy malaria infections and reducing the parasite reservoir in the human population that can infect vector mosquitoes. However, this has never been verified at a population level in a setting with intense transmission, where chronically infectious asymptomatic carriers are common and cured patients are rapidly and repeatedly re-infected.Methods: From 2001 to 2004, malaria vector densities were monitored using light traps in three Tanzanian districts. Mosquitoes were dissected to determine parous and oocyst rates. Plasmodium falciparum sporozoite rates were determined by ELISA. Sulphadoxine-pyrimethamine (SP) monotherapy was used for treatment of uncomplicated malaria in the contiguous districts of Kilombero and Ulanga throughout this period. In Rufiji district, the standard drug was changed to artesunate co-administered with SP (AS + SP) in March 2003. The effects of this change in case management on malaria parasite infection in the vectors were analysed.Results: Plasmodium falciparum entomological inoculation rates exceeded 300 infective bites per person per year at both sites over the whole period. The introduction of AS + SP in Rufiji was associated with increased oocyst prevalence (OR [95{\%} CI] = 3.9 [2.9-5.3], p <0.001), but had no consistent effect on sporozoite prevalence (OR [95{\%} CI] = 0.9 [0.7-1.2], p = 0.5). The estimated infectiousness of the human population in Rufiji was very low prior to the change in drug policy. Emergence rates and parous rates of the vectors varied substantially throughout the study period, which affected estimates of infectiousness. The latter consequently cannot be explained by the change in drug policy.Conclusions: In high perennial transmission settings, only a small proportion of infections in humans are symptomatic or treated, so case management with ACT may have little impact on overall infectiousness of the human population. Variations in infection levels in vectors largely depend on the age distribution of the mosquito population. Benefits of ACT in suppressing transmission are more likely to be evident where transmission is already low or effective vector control is widely implemented.",
keywords = "Malaria, Artemisinin-based combination therapy, Transmission reduction, PLASMODIUM-FALCIPARUM MALARIA, PAPUA-NEW-GUINEA, SUB-SAHARAN AFRICA, RURAL TANZANIA, SULFADOXINE-PYRIMETHAMINE, ANOPHELES-GAMBIAE, SOUTHERN TANZANIA, HUMAN-POPULATIONS, 6-DOSE REGIMEN, MOSQUITOS",
author = "Huho, {Bernadette J.} and Killeen, {Gerard F.} and Ferguson, {Heather M.} and Adriana Tami and Christian Lengeler and Charlwood, {J. Derek} and Aniset Kihonda and Japhet Kihonda and Kachur, {S. Patrick} and Smith, {Thomas A.} and Abdulla, {Salim M. K.}",
year = "2012",
month = "4",
day = "18",
doi = "10.1186/1475-2875-11-118",
language = "English",
volume = "11",
journal = "Malaria journal",
issn = "1475-2875",
publisher = "BioMed Central Ltd.",

}

RIS

TY - JOUR

T1 - Artemisinin-based combination therapy does not measurably reduce human infectiousness to vectors in a setting of intense malaria transmission

AU - Huho, Bernadette J.

AU - Killeen, Gerard F.

AU - Ferguson, Heather M.

AU - Tami, Adriana

AU - Lengeler, Christian

AU - Charlwood, J. Derek

AU - Kihonda, Aniset

AU - Kihonda, Japhet

AU - Kachur, S. Patrick

AU - Smith, Thomas A.

AU - Abdulla, Salim M. K.

PY - 2012/4/18

Y1 - 2012/4/18

N2 - Background: Artemisinin-based combination therapy (ACT) for treating malaria has activity against immature gametocytes. In theory, this property may complement the effect of terminating otherwise lengthy malaria infections and reducing the parasite reservoir in the human population that can infect vector mosquitoes. However, this has never been verified at a population level in a setting with intense transmission, where chronically infectious asymptomatic carriers are common and cured patients are rapidly and repeatedly re-infected.Methods: From 2001 to 2004, malaria vector densities were monitored using light traps in three Tanzanian districts. Mosquitoes were dissected to determine parous and oocyst rates. Plasmodium falciparum sporozoite rates were determined by ELISA. Sulphadoxine-pyrimethamine (SP) monotherapy was used for treatment of uncomplicated malaria in the contiguous districts of Kilombero and Ulanga throughout this period. In Rufiji district, the standard drug was changed to artesunate co-administered with SP (AS + SP) in March 2003. The effects of this change in case management on malaria parasite infection in the vectors were analysed.Results: Plasmodium falciparum entomological inoculation rates exceeded 300 infective bites per person per year at both sites over the whole period. The introduction of AS + SP in Rufiji was associated with increased oocyst prevalence (OR [95% CI] = 3.9 [2.9-5.3], p <0.001), but had no consistent effect on sporozoite prevalence (OR [95% CI] = 0.9 [0.7-1.2], p = 0.5). The estimated infectiousness of the human population in Rufiji was very low prior to the change in drug policy. Emergence rates and parous rates of the vectors varied substantially throughout the study period, which affected estimates of infectiousness. The latter consequently cannot be explained by the change in drug policy.Conclusions: In high perennial transmission settings, only a small proportion of infections in humans are symptomatic or treated, so case management with ACT may have little impact on overall infectiousness of the human population. Variations in infection levels in vectors largely depend on the age distribution of the mosquito population. Benefits of ACT in suppressing transmission are more likely to be evident where transmission is already low or effective vector control is widely implemented.

AB - Background: Artemisinin-based combination therapy (ACT) for treating malaria has activity against immature gametocytes. In theory, this property may complement the effect of terminating otherwise lengthy malaria infections and reducing the parasite reservoir in the human population that can infect vector mosquitoes. However, this has never been verified at a population level in a setting with intense transmission, where chronically infectious asymptomatic carriers are common and cured patients are rapidly and repeatedly re-infected.Methods: From 2001 to 2004, malaria vector densities were monitored using light traps in three Tanzanian districts. Mosquitoes were dissected to determine parous and oocyst rates. Plasmodium falciparum sporozoite rates were determined by ELISA. Sulphadoxine-pyrimethamine (SP) monotherapy was used for treatment of uncomplicated malaria in the contiguous districts of Kilombero and Ulanga throughout this period. In Rufiji district, the standard drug was changed to artesunate co-administered with SP (AS + SP) in March 2003. The effects of this change in case management on malaria parasite infection in the vectors were analysed.Results: Plasmodium falciparum entomological inoculation rates exceeded 300 infective bites per person per year at both sites over the whole period. The introduction of AS + SP in Rufiji was associated with increased oocyst prevalence (OR [95% CI] = 3.9 [2.9-5.3], p <0.001), but had no consistent effect on sporozoite prevalence (OR [95% CI] = 0.9 [0.7-1.2], p = 0.5). The estimated infectiousness of the human population in Rufiji was very low prior to the change in drug policy. Emergence rates and parous rates of the vectors varied substantially throughout the study period, which affected estimates of infectiousness. The latter consequently cannot be explained by the change in drug policy.Conclusions: In high perennial transmission settings, only a small proportion of infections in humans are symptomatic or treated, so case management with ACT may have little impact on overall infectiousness of the human population. Variations in infection levels in vectors largely depend on the age distribution of the mosquito population. Benefits of ACT in suppressing transmission are more likely to be evident where transmission is already low or effective vector control is widely implemented.

KW - Malaria

KW - Artemisinin-based combination therapy

KW - Transmission reduction

KW - PLASMODIUM-FALCIPARUM MALARIA

KW - PAPUA-NEW-GUINEA

KW - SUB-SAHARAN AFRICA

KW - RURAL TANZANIA

KW - SULFADOXINE-PYRIMETHAMINE

KW - ANOPHELES-GAMBIAE

KW - SOUTHERN TANZANIA

KW - HUMAN-POPULATIONS

KW - 6-DOSE REGIMEN

KW - MOSQUITOS

U2 - 10.1186/1475-2875-11-118

DO - 10.1186/1475-2875-11-118

M3 - Article

VL - 11

JO - Malaria journal

JF - Malaria journal

SN - 1475-2875

M1 - 118

ER -

ID: 5715235