Gametocyte Carriage After Seasonal Malaria Chemoprevention in Plasmodium Falciparum Infected Asymptomatic Children

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Abstract BackgroundTreatment of clinical Plasmodium falciparum malaria with sulfadoxine-pyrimethamine (SP) and amodiaquine (AQ) is associated with increased post-treatment gametocyte carriage. The effect of seasonal malaria chemoprevention (SMC) with SP and AQ on gametocyte carriage was assessed in asymptomatic Plasmodium falciparum infected children. MethodsThe study was carried out in eastern Gambia. Asymptomatic malaria infected children aged 24-59 months old eligible for SMC (SMC group) and children 5-8 years that did not receive SMC treatment (comparison group) were recruited. Baseline gametocyte prevalence was determined by molecular methods before SMC administration and 13 days after. Gametocyte carriage between the groups was compared using the Chi-squared test and within person using conditional logistic regression.ResultsDuring the 2017 and 2018 malaria transmission seasons, 65 and 75 children were recruited in the SMC and comparison groups respectively. Before SMC administration, gametocyte prevalence was 10.7% (7/65) in the SMC group and 13.3% (10/75) in the comparison group (p=0.64). At day 13 after SMC administration, this was 9.4%, (5/53) for the SMC group and 12.7%, (9/71) for the comparison group (p=0.57). Within the SMC group, gametocyte carriage before and after SMC administration was similar (OR 0.6, 95% CI 0.14 – 2.51) (p=0.48).ConclusionIn this study with relative low gametocyte prevalence prior to SMC treatment, no evidence was observed that SMC increased gametocyte carriage in asymptomatic malaria infected children.

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