title: Does radical cure of asymptomatic Plasmodium falciparum place adults in endemic areas at increased risk of recurrent symptomatic malaria?
abstract: A cohort of 197 adults in Kassena-Nankana District (northern Ghana) was radically cured of malaria parasites to study subsequent incidence of malaria infection. During the following 20 weeks of the malaria transmission season, 49% experienced clinical attacks associated with Plasmodium falciparum parasitaemia. In a group of 202 adults identically followed-up 1 year later without being treated, only 38% experienced such episodes (log-rank test for equality of survivor functions, P=0.035). Clinical attacks in radically cured individuals presented with lower parasite densities but more symptoms. Randomized studies are needed to test the hypothesis that radical cure of P. falciparum enhances the risk and severity of subsequent clinical malaria attacks.
authors.affiliation: Navrongo Health Research Centre, Ghana.
authors.forename: Seth
authors.initials: S
authors.lastname: Owusu-Agyei
authors.forename: Fred
authors.initials: F
authors.lastname: Binka
authors.forename: Kwadwo
authors.initials: K
authors.lastname: Koram
authors.forename: Francis
authors.initials: F
authors.lastname: Anto
authors.forename: Martin
authors.initials: M
authors.lastname: Adjuik
authors.forename: Francis
authors.initials: F
authors.lastname: Nkrumah
authors.forename: Tom
authors.initials: T
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D000962:Antimalarials / Q000008:administration & dosage*; D015331:Cohort Studies; D004318:Doxycycline / Q000008:administration & dosage; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D016778:Malaria, Falciparum / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011319:Primaquine / Q000008:administration & dosage; D011803:Quinine / Q000008:administration & dosage; D012008:Recurrence; D018570:Risk Assessment; D016896:Treatment Outcome
chemical_list: D000962:Antimalarials; D011803:Quinine; D011319:Primaquine; D004318:Doxycycline