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Artemisinin-based combination therapy does not measurably reduce human infectiousness to vectors in a setting of intense malaria transmission
Artemisinin-based combination therapy (ACT) for treating malaria has activity against immature gametocytes. In theory, this property may complement the effect of terminating otherwise lengthy malaria infections and reducing the parasite reservoir in the human population that can infect vector mosqui...
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| Published in: | Malaria journal 2012-04, Vol.11 (1), p.118-118, Article 118 |
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| container_end_page | 118 |
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| container_title | Malaria journal |
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| creator | Huho, Bernadette J Killeen, Gerard F Ferguson, Heather M Tami, Adriana Lengeler, Christian Charlwood, J Derek Kihonda, Aniset Kihonda, Japhet Kachur, S Patrick Smith, Thomas A Abdulla, Salim Mk |
| description | Artemisinin-based combination therapy (ACT) for treating malaria has activity against immature gametocytes. In theory, this property may complement the effect of terminating otherwise lengthy malaria infections and reducing the parasite reservoir in the human population that can infect vector mosquitoes. However, this has never been verified at a population level in a setting with intense transmission, where chronically infectious asymptomatic carriers are common and cured patients are rapidly and repeatedly re-infected.
From 2001 to 2004, malaria vector densities were monitored using light traps in three Tanzanian districts. Mosquitoes were dissected to determine parous and oocyst rates. Plasmodium falciparum sporozoite rates were determined by ELISA. Sulphadoxine-pyrimethamine (SP) monotherapy was used for treatment of uncomplicated malaria in the contiguous districts of Kilombero and Ulanga throughout this period. In Rufiji district, the standard drug was changed to artesunate co-administered with SP (AS + SP) in March 2003. The effects of this change in case management on malaria parasite infection in the vectors were analysed.
Plasmodium falciparum entomological inoculation rates exceeded 300 infective bites per person per year at both sites over the whole period. The introduction of AS + SP in Rufiji was associated with increased oocyst prevalence (OR [95%CI] = 3.9 [2.9-5.3], p |
| doi_str_mv | 10.1186/1475-2875-11-118 |
| format | article |
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From 2001 to 2004, malaria vector densities were monitored using light traps in three Tanzanian districts. Mosquitoes were dissected to determine parous and oocyst rates. Plasmodium falciparum sporozoite rates were determined by ELISA. Sulphadoxine-pyrimethamine (SP) monotherapy was used for treatment of uncomplicated malaria in the contiguous districts of Kilombero and Ulanga throughout this period. In Rufiji district, the standard drug was changed to artesunate co-administered with SP (AS + SP) in March 2003. The effects of this change in case management on malaria parasite infection in the vectors were analysed.
Plasmodium falciparum entomological inoculation rates exceeded 300 infective bites per person per year at both sites over the whole period. The introduction of AS + SP in Rufiji was associated with increased oocyst prevalence (OR [95%CI] = 3.9 [2.9-5.3], p < 0.001), but had no consistent effect on sporozoite prevalence (OR [95%CI] = 0.9 [0.7-1.2], p = 0.5). The estimated infectiousness of the human population in Rufiji was very low prior to the change in drug policy. Emergence rates and parous rates of the vectors varied substantially throughout the study period, which affected estimates of infectiousness. The latter consequently cannot be explained by the change in drug policy.
In high perennial transmission settings, only a small proportion of infections in humans are symptomatic or treated, so case management with ACT may have little impact on overall infectiousness of the human population. Variations in infection levels in vectors largely depend on the age distribution of the mosquito population. Benefits of ACT in suppressing transmission are more likely to be evident where transmission is already low or effective vector control is widely implemented.</description><identifier>ISSN: 1475-2875</identifier><identifier>EISSN: 1475-2875</identifier><identifier>DOI: 10.1186/1475-2875-11-118</identifier><identifier>PMID: 22513162</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject><![CDATA[Animals ; Antigens, Protozoan - analysis ; Antimalarials ; Antimalarials - administration & dosage ; Artemisinin-based combination therapy ; Artemisinins - administration & dosage ; Asymptomatic Diseases - epidemiology ; Biomedical research ; Busta Rhymes ; Case management ; Child, Preschool ; Colleges & universities ; Control ; Culicidae - parasitology ; Disease control ; Disease prevention ; Disease transmission ; Disease Vectors ; Distribution ; Drug Combinations ; Drug therapy ; Enzyme-Linked Immunosorbent Assay ; Female ; Health aspects ; Health sciences ; Humans ; Infant ; Infant, Newborn ; Infection ; Intervention ; Malaria ; Malaria, Falciparum - drug therapy ; Malaria, Falciparum - epidemiology ; Malaria, Falciparum - transmission ; Mortality ; Mosquitoes ; Parasites ; Parasitic diseases ; Plasmodium falciparum ; Plasmodium falciparum - isolation & purification ; Pregnancy ; Prevalence ; Pyrimethamine - administration & dosage ; Risk factors ; Sulfadoxine - administration & dosage ; Tanzania - epidemiology ; Transmission reduction]]></subject><ispartof>Malaria journal, 2012-04, Vol.11 (1), p.118-118, Article 118</ispartof><rights>COPYRIGHT 2012 BioMed Central Ltd.</rights><rights>2012 Huho et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</rights><rights>Copyright ©2012 Huho et al; licensee BioMed Central Ltd. 2012 Huho et al; licensee BioMed Central Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b650t-c0e2cdf74b0aa2c62068721b6d4db6356e0b46223137f8ef364ffa2efcde57e63</citedby><cites>FETCH-LOGICAL-b650t-c0e2cdf74b0aa2c62068721b6d4db6356e0b46223137f8ef364ffa2efcde57e63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3483232/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/1115542655?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,882,25734,27905,27906,36993,36994,44571,53772,53774</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22513162$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Huho, Bernadette J</creatorcontrib><creatorcontrib>Killeen, Gerard F</creatorcontrib><creatorcontrib>Ferguson, Heather M</creatorcontrib><creatorcontrib>Tami, Adriana</creatorcontrib><creatorcontrib>Lengeler, Christian</creatorcontrib><creatorcontrib>Charlwood, J Derek</creatorcontrib><creatorcontrib>Kihonda, Aniset</creatorcontrib><creatorcontrib>Kihonda, Japhet</creatorcontrib><creatorcontrib>Kachur, S Patrick</creatorcontrib><creatorcontrib>Smith, Thomas A</creatorcontrib><creatorcontrib>Abdulla, Salim Mk</creatorcontrib><title>Artemisinin-based combination therapy does not measurably reduce human infectiousness to vectors in a setting of intense malaria transmission</title><title>Malaria journal</title><addtitle>Malar J</addtitle><description>Artemisinin-based combination therapy (ACT) for treating malaria has activity against immature gametocytes. In theory, this property may complement the effect of terminating otherwise lengthy malaria infections and reducing the parasite reservoir in the human population that can infect vector mosquitoes. However, this has never been verified at a population level in a setting with intense transmission, where chronically infectious asymptomatic carriers are common and cured patients are rapidly and repeatedly re-infected.
From 2001 to 2004, malaria vector densities were monitored using light traps in three Tanzanian districts. Mosquitoes were dissected to determine parous and oocyst rates. Plasmodium falciparum sporozoite rates were determined by ELISA. Sulphadoxine-pyrimethamine (SP) monotherapy was used for treatment of uncomplicated malaria in the contiguous districts of Kilombero and Ulanga throughout this period. In Rufiji district, the standard drug was changed to artesunate co-administered with SP (AS + SP) in March 2003. The effects of this change in case management on malaria parasite infection in the vectors were analysed.
Plasmodium falciparum entomological inoculation rates exceeded 300 infective bites per person per year at both sites over the whole period. The introduction of AS + SP in Rufiji was associated with increased oocyst prevalence (OR [95%CI] = 3.9 [2.9-5.3], p < 0.001), but had no consistent effect on sporozoite prevalence (OR [95%CI] = 0.9 [0.7-1.2], p = 0.5). The estimated infectiousness of the human population in Rufiji was very low prior to the change in drug policy. Emergence rates and parous rates of the vectors varied substantially throughout the study period, which affected estimates of infectiousness. The latter consequently cannot be explained by the change in drug policy.
In high perennial transmission settings, only a small proportion of infections in humans are symptomatic or treated, so case management with ACT may have little impact on overall infectiousness of the human population. Variations in infection levels in vectors largely depend on the age distribution of the mosquito population. Benefits of ACT in suppressing transmission are more likely to be evident where transmission is already low or effective vector control is widely implemented.</description><subject>Animals</subject><subject>Antigens, Protozoan - analysis</subject><subject>Antimalarials</subject><subject>Antimalarials - administration & dosage</subject><subject>Artemisinin-based combination therapy</subject><subject>Artemisinins - administration & dosage</subject><subject>Asymptomatic Diseases - epidemiology</subject><subject>Biomedical research</subject><subject>Busta Rhymes</subject><subject>Case management</subject><subject>Child, Preschool</subject><subject>Colleges & universities</subject><subject>Control</subject><subject>Culicidae - parasitology</subject><subject>Disease control</subject><subject>Disease prevention</subject><subject>Disease transmission</subject><subject>Disease Vectors</subject><subject>Distribution</subject><subject>Drug Combinations</subject><subject>Drug therapy</subject><subject>Enzyme-Linked Immunosorbent Assay</subject><subject>Female</subject><subject>Health aspects</subject><subject>Health sciences</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Infection</subject><subject>Intervention</subject><subject>Malaria</subject><subject>Malaria, Falciparum - drug therapy</subject><subject>Malaria, Falciparum - epidemiology</subject><subject>Malaria, Falciparum - transmission</subject><subject>Mortality</subject><subject>Mosquitoes</subject><subject>Parasites</subject><subject>Parasitic diseases</subject><subject>Plasmodium falciparum</subject><subject>Plasmodium falciparum - isolation & purification</subject><subject>Pregnancy</subject><subject>Prevalence</subject><subject>Pyrimethamine - administration & dosage</subject><subject>Risk factors</subject><subject>Sulfadoxine - administration & dosage</subject><subject>Tanzania - epidemiology</subject><subject>Transmission reduction</subject><issn>1475-2875</issn><issn>1475-2875</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNqFUk1v1DAQjRCIlsKdE7LEhcuW-Du9IFUrPipV4gJny7HHu14l9mInlfoj-p-ZZcvSRUXIVhzPvHmemTdN85q255R26j0VWi5Yhx9KcXdPmtOD6emD_5PmRa2btqW60-x5c8KYpJwqdtrcXZYJxlhjimnR2wqeuDz2Mdkp5kSmNRS7vSU-QyUpT2QEW-di--GWFPCzA7KeR5tITAEchsw1Qa1kyuQG77lU9BBLKkxTTCuSA94nSBXIaAdboiVTsaliBhXfe9k8C3ao8Or-PGu-f_r4bfllcf3189Xy8nrRK9lOC9cCcz5o0bfWMqdYq7Au2isvfK-4VND2QjHGKdehg8CVCMEyCM6D1KD4WXO15_XZbsy2xNGWW5NtNL8MuayMLVN0AxitufS-A-eZEFrpi1b3ggkptRChawNyfdhzbed-BO8gYUXDEemxJ8W1WeUbw0XHGa6zZrkn6GP-B8GxBwUyO2nNTlpDKe4OWd7dp1HyjxnqZLCnDobBJkBVDOotFRNc6f9DKUN2IQRH6Nu_oJs8l4TaIIpKKZiS8g9qZbFjOAoZ83Q7UnMpuWD8ouO7Z88fQeHyOIAuJwgR7UcB7T7AlVxrgXDoCW13NavHuvDmoRiHgN8Dz38C2xsCGQ</recordid><startdate>20120418</startdate><enddate>20120418</enddate><creator>Huho, Bernadette J</creator><creator>Killeen, Gerard F</creator><creator>Ferguson, Heather M</creator><creator>Tami, Adriana</creator><creator>Lengeler, Christian</creator><creator>Charlwood, J Derek</creator><creator>Kihonda, Aniset</creator><creator>Kihonda, Japhet</creator><creator>Kachur, S Patrick</creator><creator>Smith, Thomas A</creator><creator>Abdulla, Salim Mk</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><general>BMC</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7SS</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>F1W</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>H95</scope><scope>H97</scope><scope>K9.</scope><scope>L.G</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20120418</creationdate><title>Artemisinin-based combination therapy does not measurably reduce human infectiousness to vectors in a setting of intense malaria transmission</title><author>Huho, Bernadette J ; Killeen, Gerard F ; Ferguson, Heather M ; Tami, Adriana ; Lengeler, Christian ; Charlwood, J Derek ; Kihonda, Aniset ; Kihonda, Japhet ; Kachur, S Patrick ; Smith, Thomas A ; Abdulla, Salim Mk</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b650t-c0e2cdf74b0aa2c62068721b6d4db6356e0b46223137f8ef364ffa2efcde57e63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Animals</topic><topic>Antigens, Protozoan - analysis</topic><topic>Antimalarials</topic><topic>Antimalarials - administration & dosage</topic><topic>Artemisinin-based combination therapy</topic><topic>Artemisinins - administration & dosage</topic><topic>Asymptomatic Diseases - epidemiology</topic><topic>Biomedical research</topic><topic>Busta Rhymes</topic><topic>Case management</topic><topic>Child, Preschool</topic><topic>Colleges & universities</topic><topic>Control</topic><topic>Culicidae - parasitology</topic><topic>Disease control</topic><topic>Disease prevention</topic><topic>Disease transmission</topic><topic>Disease Vectors</topic><topic>Distribution</topic><topic>Drug Combinations</topic><topic>Drug therapy</topic><topic>Enzyme-Linked Immunosorbent Assay</topic><topic>Female</topic><topic>Health aspects</topic><topic>Health sciences</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Infection</topic><topic>Intervention</topic><topic>Malaria</topic><topic>Malaria, Falciparum - drug therapy</topic><topic>Malaria, Falciparum - epidemiology</topic><topic>Malaria, Falciparum - transmission</topic><topic>Mortality</topic><topic>Mosquitoes</topic><topic>Parasites</topic><topic>Parasitic diseases</topic><topic>Plasmodium falciparum</topic><topic>Plasmodium falciparum - isolation & purification</topic><topic>Pregnancy</topic><topic>Prevalence</topic><topic>Pyrimethamine - administration & dosage</topic><topic>Risk factors</topic><topic>Sulfadoxine - administration & dosage</topic><topic>Tanzania - epidemiology</topic><topic>Transmission reduction</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Huho, Bernadette J</creatorcontrib><creatorcontrib>Killeen, Gerard F</creatorcontrib><creatorcontrib>Ferguson, Heather M</creatorcontrib><creatorcontrib>Tami, Adriana</creatorcontrib><creatorcontrib>Lengeler, Christian</creatorcontrib><creatorcontrib>Charlwood, J Derek</creatorcontrib><creatorcontrib>Kihonda, Aniset</creatorcontrib><creatorcontrib>Kihonda, Japhet</creatorcontrib><creatorcontrib>Kachur, S Patrick</creatorcontrib><creatorcontrib>Smith, Thomas A</creatorcontrib><creatorcontrib>Abdulla, Salim Mk</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Virology and AIDS Abstracts</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>ASFA: Aquatic Sciences and Fisheries Abstracts</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Aquatic Science & Fisheries Abstracts (ASFA) 1: Biological Sciences & Living Resources</collection><collection>Aquatic Science & Fisheries Abstracts (ASFA) 3: Aquatic Pollution & Environmental Quality</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Aquatic Science & Fisheries Abstracts (ASFA) Professional</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Malaria journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Huho, Bernadette J</au><au>Killeen, Gerard F</au><au>Ferguson, Heather M</au><au>Tami, Adriana</au><au>Lengeler, Christian</au><au>Charlwood, J Derek</au><au>Kihonda, Aniset</au><au>Kihonda, Japhet</au><au>Kachur, S Patrick</au><au>Smith, Thomas A</au><au>Abdulla, Salim Mk</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Artemisinin-based combination therapy does not measurably reduce human infectiousness to vectors in a setting of intense malaria transmission</atitle><jtitle>Malaria journal</jtitle><addtitle>Malar J</addtitle><date>2012-04-18</date><risdate>2012</risdate><volume>11</volume><issue>1</issue><spage>118</spage><epage>118</epage><pages>118-118</pages><artnum>118</artnum><issn>1475-2875</issn><eissn>1475-2875</eissn><abstract>Artemisinin-based combination therapy (ACT) for treating malaria has activity against immature gametocytes. In theory, this property may complement the effect of terminating otherwise lengthy malaria infections and reducing the parasite reservoir in the human population that can infect vector mosquitoes. However, this has never been verified at a population level in a setting with intense transmission, where chronically infectious asymptomatic carriers are common and cured patients are rapidly and repeatedly re-infected.
From 2001 to 2004, malaria vector densities were monitored using light traps in three Tanzanian districts. Mosquitoes were dissected to determine parous and oocyst rates. Plasmodium falciparum sporozoite rates were determined by ELISA. Sulphadoxine-pyrimethamine (SP) monotherapy was used for treatment of uncomplicated malaria in the contiguous districts of Kilombero and Ulanga throughout this period. In Rufiji district, the standard drug was changed to artesunate co-administered with SP (AS + SP) in March 2003. The effects of this change in case management on malaria parasite infection in the vectors were analysed.
Plasmodium falciparum entomological inoculation rates exceeded 300 infective bites per person per year at both sites over the whole period. The introduction of AS + SP in Rufiji was associated with increased oocyst prevalence (OR [95%CI] = 3.9 [2.9-5.3], p < 0.001), but had no consistent effect on sporozoite prevalence (OR [95%CI] = 0.9 [0.7-1.2], p = 0.5). The estimated infectiousness of the human population in Rufiji was very low prior to the change in drug policy. Emergence rates and parous rates of the vectors varied substantially throughout the study period, which affected estimates of infectiousness. The latter consequently cannot be explained by the change in drug policy.
In high perennial transmission settings, only a small proportion of infections in humans are symptomatic or treated, so case management with ACT may have little impact on overall infectiousness of the human population. Variations in infection levels in vectors largely depend on the age distribution of the mosquito population. Benefits of ACT in suppressing transmission are more likely to be evident where transmission is already low or effective vector control is widely implemented.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>22513162</pmid><doi>10.1186/1475-2875-11-118</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Malaria journal, 2012-04, Vol.11 (1), p.118-118, Article 118 |
| issn | 1475-2875 1475-2875 |
| language | eng |
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| source | Publicly Available Content Database; PubMed Central |
| subjects | Animals Antigens, Protozoan - analysis Antimalarials Antimalarials - administration & dosage Artemisinin-based combination therapy Artemisinins - administration & dosage Asymptomatic Diseases - epidemiology Biomedical research Busta Rhymes Case management Child, Preschool Colleges & universities Control Culicidae - parasitology Disease control Disease prevention Disease transmission Disease Vectors Distribution Drug Combinations Drug therapy Enzyme-Linked Immunosorbent Assay Female Health aspects Health sciences Humans Infant Infant, Newborn Infection Intervention Malaria Malaria, Falciparum - drug therapy Malaria, Falciparum - epidemiology Malaria, Falciparum - transmission Mortality Mosquitoes Parasites Parasitic diseases Plasmodium falciparum Plasmodium falciparum - isolation & purification Pregnancy Prevalence Pyrimethamine - administration & dosage Risk factors Sulfadoxine - administration & dosage Tanzania - epidemiology Transmission reduction |
| title | Artemisinin-based combination therapy does not measurably reduce human infectiousness to vectors in a setting of intense malaria transmission |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-19T15%3A17%3A58IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_doaj_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Artemisinin-based%20combination%20therapy%20does%20not%20measurably%20reduce%20human%20infectiousness%20to%20vectors%20in%20a%20setting%20of%20intense%20malaria%20transmission&rft.jtitle=Malaria%20journal&rft.au=Huho,%20Bernadette%20J&rft.date=2012-04-18&rft.volume=11&rft.issue=1&rft.spage=118&rft.epage=118&rft.pages=118-118&rft.artnum=118&rft.issn=1475-2875&rft.eissn=1475-2875&rft_id=info:doi/10.1186/1475-2875-11-118&rft_dat=%3Cgale_doaj_%3EA534239837%3C/gale_doaj_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-b650t-c0e2cdf74b0aa2c62068721b6d4db6356e0b46223137f8ef364ffa2efcde57e63%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=1115542655&rft_id=info:pmid/22513162&rft_galeid=A534239837&rfr_iscdi=true |