Higher gametocyte production and mosquito infectivity in chronic compared to incident Plasmodium falciparum infections

Aissata Barry, John Bradley, Will Stone, Moussa W. Guelbeogo, Kjerstin Lanke, Alphonse Ouedraogo, Issiaka Soulama, Issa Nébié, Samuel S. Serme, Lynn Grignard, Catriona Patterson, Lindsey Wu, Jessica J. Briggs, Owen Janson, Shehu S. Awandu, Mireille Ouedraogo, Casimire W. Tarama, Désiré Kargougou, Soumanaba Zongo, Sodiomon B. Sirima, Matthias Marti, Chris Drakeley, Alfred B. Tiono and Teun Bousema ()
Additional contact information
Aissata Barry: Centre National de Recherche et de Formation sur le Paludisme (CNRFP)
John Bradley: MRC International Statistics and Epidemiology Group, London School of Hygiene and Tropical Medicine
Will Stone: London School of Hygiene and Tropical Medicine
Moussa W. Guelbeogo: Centre National de Recherche et de Formation sur le Paludisme (CNRFP)
Kjerstin Lanke: Radboud University Medical Centre
Alphonse Ouedraogo: Centre National de Recherche et de Formation sur le Paludisme (CNRFP)
Issiaka Soulama: Centre National de Recherche et de Formation sur le Paludisme (CNRFP)
Issa Nébié: Centre National de Recherche et de Formation sur le Paludisme (CNRFP)
Samuel S. Serme: Centre National de Recherche et de Formation sur le Paludisme (CNRFP)
Lynn Grignard: London School of Hygiene and Tropical Medicine
Catriona Patterson: London School of Hygiene and Tropical Medicine
Lindsey Wu: London School of Hygiene and Tropical Medicine
Jessica J. Briggs: University of California San Francisco
Owen Janson: University of California San Francisco
Shehu S. Awandu: Radboud University Medical Centre
Mireille Ouedraogo: Centre National de Recherche et de Formation sur le Paludisme (CNRFP)
Casimire W. Tarama: Centre National de Recherche et de Formation sur le Paludisme (CNRFP)
Désiré Kargougou: Centre National de Recherche et de Formation sur le Paludisme (CNRFP)
Soumanaba Zongo: Centre National de Recherche et de Formation sur le Paludisme (CNRFP)
Sodiomon B. Sirima: Centre National de Recherche et de Formation sur le Paludisme (CNRFP)
Matthias Marti: Wellcome Centre for Integrative Parasitology, University of Glasgow
Chris Drakeley: MRC International Statistics and Epidemiology Group, London School of Hygiene and Tropical Medicine
Alfred B. Tiono: Centre National de Recherche et de Formation sur le Paludisme (CNRFP)
Teun Bousema: Radboud University Medical Centre

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

Abstract: Abstract Plasmodium falciparum gametocyte kinetics and infectivity may differ between chronic and incident infections. In the current study, we assess parasite kinetics and infectivity to mosquitoes among children (aged 5–10 years) from Burkina Faso with (a) incident infections following parasite clearance (n = 48) and (b) chronic asymptomatic infections (n = 60). In the incident infection cohort, 92% (44/48) of children develop symptoms within 35 days, compared to 23% (14/60) in the chronic cohort. All individuals with chronic infection carried gametocytes or developed them during follow-up, whereas only 35% (17/48) in the incident cohort produce gametocytes before becoming symptomatic and receiving treatment. Parasite multiplication rate (PMR) and the relative abundance of ap2-g and gexp-5 transcripts are positively associated with gametocyte production. Antibody responses are higher and PMR lower in chronic infections. The presence of symptoms and sexual stage immune responses are associated with reductions in gametocyte infectivity to mosquitoes. We observe that most incident infections require treatment before the density of mature gametocytes is sufficient to infect mosquitoes. In contrast, chronic, asymptomatic infections represent a significant source of mosquito infections. Our observations support the notion that malaria transmission reduction may be expedited by enhanced case management, involving both symptom-screening and infection detection.

Date: 2021
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DOI: 10.1038/s41467-021-22573-7

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