Emergence and clearance of gametocytes in uncomplicated Plasmodium falciparum malaria.
We reviewed the records of 1,175 patients with uncomplicated Plasmodium falciparum malaria to determine the prevalence of gametocytemia. All patients were admitted and received artemisinin combination therapy. Blood films were checked daily until discharge. Circulating gametocytes were observed in 240 (20.2%) of patients and in most cases (222 of 240, 92.5%) gametocytemia was detected during the first 24 hours after admission. Gametocytes were first seen in 174 cases on admission, in 24 cases at 12 hours, and in 24 cases at 24 hours. The longest interval between admission and first appearance of gametocytes was 192 hours. The median gametocyte clearance time was 163 hours (range = 12-806) in the 219 patients in whom gametocytemia resolved. However, 21 patients (9.8%) still had gametocytemia on discharge. Gametocytemia generally is present within the first 24 hours after admission, and emerges in only 1.9% of patients later on during treatment with artemisinin.
Piyaphanee
Watcharapong
W
Department of Clinical Tropical Medicine and Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Krudsood
Srivicha
S
Tangpukdee
Noppadon
N
Thanachartwet
Wipa
W
Silachamroon
Udomsak
U
Phophak
Nantaporn
N
Duangdee
Chatnapra
C
Haoharn
Orathai
O
Faithong
Suparat
S
Wilairatana
Polrat
P
Leowattana
Wattana
W
Looareesuwan
Sornchai
S
D000293:Adolescent; D000328:Adult; D000818:Animals; D000962:Antimalarials / Q000627:therapeutic use*; D037621:Artemisinins / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005718:Gametogenesis; D006801:Humans; D016778:Malaria, Falciparum / Q000097:blood / Q000188:drug therapy / Q000469:parasitology*; D008297:Male; D008875:Middle Aged; D018512:Parasitemia / Q000097:blood / Q000188:drug therapy / Q000469:parasitology; D010963:Plasmodium falciparum / Q000254:growth & development*; D012189:Retrospective Studies; D012717:Sesquiterpenes / Q000627:therapeutic use*
D000962:Antimalarials; D037621:Artemisinins; D012717:Sesquiterpenes; C031327:artemisinin