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dc.contributor.authorFontoura, Pablo S.en_US
dc.contributor.authorFinco, Bruna F.en_US
dc.contributor.authorLima, Nathália F.en_US
dc.contributor.authorde Carvalho, Jaques F.en_US
dc.contributor.authorVinetz, Joseph M.en_US
dc.contributor.authorCastro, Márcia C.en_US
dc.contributor.authorFerreira, Marcelo U.en_US
dc.date.accessioned2017-02-18T01:59:18Z
dc.date.issued2016en_US
dc.identifier.citationFontoura, Pablo S., Bruna F. Finco, Nathália F. Lima, Jaques F. de Carvalho, Joseph M. Vinetz, Márcia C. Castro, and Marcelo U. Ferreira. 2016. “Reactive Case Detection for Plasmodium vivax Malaria Elimination in Rural Amazonia.” PLoS Neglected Tropical Diseases 10 (12): e0005221. doi:10.1371/journal.pntd.0005221. http://dx.doi.org/10.1371/journal.pntd.0005221.en
dc.identifier.issn1935-2727en
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:30371129
dc.description.abstractBackground: Malaria burden in Brazil has reached its lowest levels in 35 years and Plasmodium vivax now accounts for 84% of cases countrywide. Targeting residual malaria transmission entrenched in the Amazon is the next major challenge for ongoing elimination efforts. Better strategies are urgently needed to address the vast reservoir of asymptomatic P. vivax carriers in this and other areas approaching malaria elimination. Methods: We evaluated a reactive case detection (RCD) strategy tailored for P. vivax transmission in farming settlements in the Amazon Basin of Brazil. Over six months, 41 cases detected by passive surveillance triggered four rounds of RCD (0, 30, 60, and 180 days after index case enrollment), using microscopy- and quantitative real-time polymerase chain reaction (qPCR)-based diagnosis, comprising subjects sharing the household (HH) with the index case (n = 163), those living in the 5 nearest HHs within 3 km (n = 878), and individuals from 5 randomly chosen control HHs located > 5 km away from index cases (n = 841). Correlates of infection were identified with mixed-effects logistic regression models. Molecular genotyping was used to infer local parasite transmission networks. Principal findings/Conclusions Subjects in index and neighbor HHs were significantly more likely to be parasitemic than control HH members, after adjusting for potential confounders, and together harbored > 90% of the P. vivax biomass in study subjects. Clustering patterns were temporally stable. Four rounds of microscopy-based RCD would identify only 49.5% of the infections diagnosed by qPCR, but 76.8% of the total parasite biomass circulating in the proximity of index HHs. However, control HHs accounted for 27.6% of qPCR-positive samples, 92.6% of them from asymptomatic carriers beyond the reach of RCD. Molecular genotyping revealed high P. vivax diversity, consistent with complex transmission networks and multiple sources of infection within clusters, potentially complicating malaria elimination efforts.en
dc.language.isoen_USen
dc.publisherPublic Library of Scienceen
dc.relation.isversionofdoi:10.1371/journal.pntd.0005221en
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC5179126/pdf/en
dash.licenseLAAen_US
dc.subjectMedicine and Health Sciencesen
dc.subjectParasitic Diseasesen
dc.subjectBiology and Life Sciencesen
dc.subjectParasitologyen
dc.subjectParasite Groupsen
dc.subjectApicomplexaen
dc.subjectPlasmodiumen
dc.subjectMalariaen
dc.subjectTropical Diseasesen
dc.subjectOrganismsen
dc.subjectProtozoansen
dc.subjectParasitic Protozoansen
dc.subjectMalarial Parasitesen
dc.subjectInfectious Diseasesen
dc.subjectInfectious Disease Controlen
dc.subjectPlasmodium Vivaxen
dc.subjectPeople and placesen
dc.subjectGeographical locationsen
dc.subjectSouth Americaen
dc.subjectBrazilen
dc.subjectAnatomyen
dc.subjectBody Fluidsen
dc.subjectBlooden
dc.subjectPhysiologyen
dc.subjectHematologyen
dc.titleReactive Case Detection for Plasmodium vivax Malaria Elimination in Rural Amazoniaen
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden
dc.relation.journalPLoS Neglected Tropical Diseasesen
dash.depositing.authorCastro, Márcia C.en_US
dc.date.available2017-02-18T01:59:18Z
dc.identifier.doi10.1371/journal.pntd.0005221*
dash.contributor.affiliatedCastro, Marcia


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