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测量Plasmodium falciparum人口普查人口规模的变化,以应对连续的疟疾控制干预措施

Kathryn E Tiedje, Qi Zhan, Shazia Ruybal-Pesantez

medRxiv : the preprint server for health sciences

|June 9, 2023

概括

一种新的方法通过基因多样性来测量Plasmodium falciparum寄生虫种群规模. 疟疾干预减少了寄生虫的数量,但种群迅速反弹,显示了寄生虫的弹性.

科学领域:

疟疾学疟疾学
寄生虫学的寄生虫学
人口遗传学人口遗传学

背景情况:

杆菌感染是一个重大的全球卫生挑战,特别是在撒哈拉以南非洲.
*目前的流行病学工具往往侧重于人类宿主,可能低估了寄生虫负担和弹性.
*了解寄生虫种群动态对于有效的疟疾控制策略至关重要.

研究的目的:

*引入一个新的终点",人口普查人口规模",以量化 *P. falciparum* 寄生虫种群.
*评估疟疾干预措施 (IRS和SMC) 对寄生虫种群规模和多样性的影响.
*为了评估 *P. falciparum* 种群的抵抗力,以控制努力.

主要方法:

*开发了贝叶斯的方法来估计感染的多重性 (MOI_var) 基于var基因的多样性.
*通过在人类人口中总结MOI_var来计算人口普查人口规模.
*通过加纳北部 (2012-2017) 的连续干预,监测了寄生虫种群大小和多样性的变化.

主要成果:

*室内残留喷雾 (IRS) 显著降低了寄生虫的流行率,传播强度,品种多样性,MOI和种群规模.
*这些减少是暂时的,在IRS停止和引入季节性疟疾化学预防 (SMC) 后的32个月内,寄生虫种群反弹.
*SMC干预措施防止了年幼儿童 (1-5岁) 的种群反弹,但总体上寄生虫种群仍然很大,基因多样化,这是高传播系统的特征.

结论:

*"人口普查人口规模"为评估疟疾流行病学和控制提供了一个有价值的新指标.
* *P. falciparum*表现出了显著的弹性,寄生虫种群在IRS和SMC造成重大干扰后迅速恢复.
*短期的疟疾干预措施可能不足以在高负担环境中长期减少大型和基因多样化的寄生虫库.

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