Carrier State

Publication Title: 
Pharmacotherapy

Methicillin-resistant Staphylococcus aureus (MRSA) bacteria are a common cause of hospital- and community-acquired infections. Persons may have asymptomatic colonization with MRSA in the nares, axillae, perineum, or groin. Since MRSA colonization often precedes infection, and infection is associated with significant morbidity and mortality, there is great interest in preventing the transmission of MRSA and decolonizing persons who harbor these bacteria. We provide an evidence-based review of MRSA decolonization agents.

Author(s): 
McConeghy, Kevin W.
Mikolich, Dennis J.
LaPlante, Kerry L.
Publication Title: 
The American Journal of Tropical Medicine and Hygiene

The factors affecting the development of patent Plasmodium falciparum gametocytemia were assessed in 5,682 patients entered prospectively into a series of antimalarial drug trials conducted in an area of low and seasonal transmission on the western border of Thailand. Of the 4,565 patients with admission thick smear assessments, 110 (2.4%) had gametocytemia. During the follow-up period 170 (3%) of all patients developed patent gametocytemia, which in 89% had developed by day 14 following treatment.

Author(s): 
Price, R.
Nosten, F.
Simpson, J. A.
Luxemburger, C.
Phaipun, L.
ter Kuile, F.
van Vugt, M.
Chongsuphajaisiddhi, T.
White, N. J.
Publication Title: 
The American Journal of Tropical Medicine and Hygiene

An open randomized controlled study of mefloquine-artesunate and mefloquine-primaquine for the treatment of uncomplicated Plasmodium falciparum malaria was carried out in Kanchanaburi in the Saiyok District in western Thailand. Weekly parasite counts from thick and thin blood films were done for six weeks. The gametocyte carriage rate was calculated and compared between the two treatment groups. Gametocytes on presentation, recrudescent infection, and reinfection were the significant factors associated with subsequent development of gametocytemia.

Author(s): 
Suputtamongkol, Yupin
Chindarat, Supat
Silpasakorn, Saowalak
Chaikachonpatd, Suchada
Lim, Kimheng
Chanthapakajee, Kittiporn
Kaewkaukul, Naparat
Thamlikitkul, Visanu
Publication Title: 
Antimicrobial Agents and Chemotherapy

The gametocidal activities of chloroquine and artesunate were compared. The relative risk (RR) of having detectable gametocytes appear after treatment initiation was lower in artesunate-treated patients (n = 792) than in chloroquine-treated patients (n = 695) (RR = 0.29; 95% CI = 0.2 to 0.40; P < 0.0001). The duration and magnitude of gametocyte carriage were also lower for artesunate than chloroquine. By reducing the transmission of Plasmodium vivax to the vector, artesunate could therefore reduce the incidence of P. vivax malaria.

Author(s): 
Nacher, Mathieu
Silachamroon, Udomsak
Singhasivanon, Pratap
Wilairatana, Polrat
Phumratanaprapin, Weerapong
Fontanet, Arnaud
Looareesuwan, Sornchai
Publication Title: 
The American Journal of Tropical Medicine and Hygiene

The choice of artemisinin-based combination that is being adopted for malaria treatment in sub-Saharan Africa may depend on several factors, including cost, efficacy, side effects, and simplicity of administration. We tested the hypothesis that artesunate-sulfamethoxypyrazine-pyrimethamine is as efficacious as the four-dose regimen of artemether-lumefantrine for treatment of Plasmodium falciparum malaria. The study was carried out during two transmission seasons (2003 and 2004) in Sotuba, Mali. Participants at least 6 months of age with uncomplicated P.

Author(s): 
Sagara, Issaka
Dicko, Alassane
Djimde, Abdoulaye
Guindo, Ousmane
Kone, Mamady
Tolo, Youssouf
Thera, Mahamadou A.
Sogoba, Moussa
Fofana, Moussa
Ouattara, Amed
Sissoko, Mady
Jansen, Herwig F.
Doumbo, Ogobara K.
Publication Title: 
PloS One

BACKGROUND: In areas of seasonal malaria transmission, treatment of asymptomatic carriers of malaria parasites, whose parasitaemia persists at low densities throughout the dry season, could be a useful strategy for malaria control. We carried out a randomized trial to compare two drug regimens for clearance of parasitaemia in order to identify the optimum regimen for use in mass drug administration in the dry season.

Author(s): 
El-Sayed, Badria
El-Zaki, Salah-Eldin
Babiker, Hamza
Gadalla, Nahla
Ageep, Tellal
Mansour, Fathi
Baraka, Omer
Milligan, Paul
Babiker, Ahmed
Publication Title: 
Malaria Journal

BACKGROUND: The aim of this study was to identify and compare factors associated with Plasmodium falciparum gametocyte carriage in three regions of differing malaria endemicity. METHODS: Retrospective data from Thailand, The Gambia and Tanzania were used. The data came from large prospective field-based clinical trials, which investigated gametocyte carriage after different anti-malarial drug treatments.

Author(s): 
Stepniewska, Kasia
Price, Ric N.
Sutherland, Colin J.
Drakeley, Chris J.
von Seidlein, Lorenz
Nosten, François
White, Nicholas J.
Publication Title: 
PloS One

BACKGROUND: Single nucleotide polymorphisms (SNPs) in the dhfr and dhps genes are associated with sulphadoxine-pyrimethamine (SP) treatment failure and gametocyte carriage. This may result in enhanced transmission of mutant malaria parasites, as previously shown for chloroquine resistant parasites. In the present study, we determine the association between parasite mutations, submicroscopic P. falciparum gametocytemia and malaria transmission to mosquitoes.

Author(s): 
Oesterholt, Mayke J. A. M.
Alifrangis, Michael
Sutherland, Colin J.
Omar, Sabah A.
Sawa, Patrick
Howitt, Christina
Gouagna, Louis C.
Sauerwein, Robert W.
Bousema, Teun
Publication Title: 
Malaria Journal

BACKGROUND: Increased investment and commitment to malaria prevention and treatment strategies across Africa has produced impressive reductions in the incidence of this disease. Nevertheless, it is clear that further interventions will be necessary to meet the international target of a reversal in the incidence of malaria by 2015. This article discusses the prospective role of an innovative malaria control strategy - the community-based treatment of asymptomatic carriers of Plasmodium falciparum, with artemisinin-based combination therapy (ACT).

Author(s): 
Ogutu, Bernhards
Tiono, Alfred B.
Makanga, Michael
Premji, Zulfiqarali
Gbadoé, Adama Dodji
Ubben, David
Marrast, Anne Claire
Gaye, Oumar
Publication Title: 
Malaria Journal

BACKGROUND: There is renewed acknowledgement that targeting gametocytes is essential for malaria control and elimination efforts. Simple mathematical models were fitted to data from clinical trials in order to determine the mean gametocyte circulation time and duration of gametocyte carriage in treated malaria patients. METHODS: Data were used from clinical trials from East Africa.

Author(s): 
Bousema, Teun
Okell, Lucy
Shekalaghe, Seif
Griffin, Jamie T.
Omar, Sabah
Sawa, Patrick
Sutherland, Colin
Sauerwein, Robert
Ghani, Azra C.
Drakeley, Chris

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