Genotyping cognate Plasmodium falciparum in humans and mosquitoes to estimate onward transmission of asymptomatic infections

Kelsey M. Sumner, Elizabeth Freedman, Lucy Abel, Andrew Obala, Brian W. Pence, Amy Wesolowski, Steven R. Meshnick, Wendy Prudhomme-O’Meara and Steve M. Taylor ()
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Kelsey M. Sumner: University of North Carolina
Elizabeth Freedman: Duke University
Lucy Abel: Moi Teaching and Referral Hospital
Andrew Obala: Moi University
Brian W. Pence: University of North Carolina
Amy Wesolowski: Johns Hopkins Bloomberg School of Public Health
Steven R. Meshnick: University of North Carolina
Wendy Prudhomme-O’Meara: Duke University
Steve M. Taylor: Duke University

Nature Communications, 2021, vol. 12, issue 1, 1-12

Abstract: Abstract Malaria control may be enhanced by targeting reservoirs of Plasmodium falciparum transmission. One putative reservoir is asymptomatic malaria infections and the scale of their contribution to transmission in natural settings is not known. We assess the contribution of asymptomatic malaria to onward transmission using a 14-month longitudinal cohort of 239 participants in a high transmission site in Western Kenya. We identify P. falciparum in asymptomatically- and symptomatically-infected participants and naturally-fed mosquitoes from their households, genotype all parasites using deep sequencing of the parasite genes pfama1 and pfcsp, and use haplotypes to infer participant-to-mosquito transmission through a probabilistic model. In 1,242 infections (1,039 in people and 203 in mosquitoes), we observe 229 (pfcsp) and 348 (pfama1) unique parasite haplotypes. Using these to link human and mosquito infections, compared with symptomatic infections, asymptomatic infections more than double the odds of transmission to a mosquito among people with both infection types (Odds Ratio: 2.56; 95% Confidence Interval (CI): 1.36–4.81) and among all participants (OR 2.66; 95% CI: 2.05–3.47). Overall, 94.6% (95% CI: 93.1–95.8%) of mosquito infections likely resulted from asymptomatic infections. In high transmission areas, asymptomatic infections are the major contributor to mosquito infections and may be targeted as a component of transmission reduction.

Date: 2021
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Persistent link: https://EconPapers.repec.org/RePEc:nat:natcom:v:12:y:2021:i:1:d:10.1038_s41467-021-21269-2

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DOI: 10.1038/s41467-021-21269-2

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