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AGE-DEPENDENT DISTRIBUTION OF PLASMODIUM FALCIPARUM GAMETOCYTES QUANTIFIED BY PFS25 REAL-TIME QT-NASBA IN A CROSS-SECTIONAL STUDY IN BURKINA FASO

Sexual stages of Plasmodium falciparum play a key role in the transmission of malaria. Studies on gametocytes are generally based on microscopic detection, but more sensitive detection methods for P. falciparum gametocytes frequently detect sub-patent gametocytes. We used Pfs25 mRNA quantitative-nucleic acid sequence-based amplification (QT-NASBA) to quantify gametocytes in 412 samples from a cross-sectional study in Burkina Faso, covering all age groups, to determine age-related patterns in gametocyte carriage and gametocyte density. The more sensitive QT-NASBA technique gave estimates of gametocyte prevalence 3.3-fold higher than microscopy (70.1% versus 21.4%, respectively). Prevalence of gametocytes significantly decreased with age. Our data suggest that asexual parasite densities are primarily responsible for the age-related decrease of gametocyte prevalence, possibly because of developing asexual stage immunity. Gametocyte densities decrease also with age, primarily because of decreasing asexual parasite densities; only a small but significant age effect on gametocyte density may be caused by developing sexual stage–specific immunity.

Received July 31, 2006. Accepted for publication January 11, 2007.

Acknowledgments: The authors thank the people participating in the study for their cooperation; the staff of the parasitology laboratory at CNRFP in Burkina Faso; Professor A. S. Ouattara for supervision; Marga van de Vegte-Bolmer of Radboud University Nijmegen for gametocyte production in the in vitro parasite culture; and Gerard Schoone and Henk Schallig of KIT Biomedical Research Amsterdam and Sake de Vlas of Erasmus University Rotterdam for advice, support, and motivation during the study and preparation of the manuscript.

Financial support: This work was supported by the Technology Foundation STW (Grant NFA6009) and WOTRO (WM 93–350).

^* Address correspondence to André Lin Ouédraogo, Département des Sciences Biomédicales, Centre National de Recherche et de Formation sur le Paludisme, 01 BP 2208 Ouagadougou 01, Burkina Faso. E-mail: andre_lin_o{at}yahoo.fr

Authors’ addresses: André Lin Ouédraogo, Issa Nébié, and Nadine Cuzin-Ouattara, Département des Sciences Biomédicales, Centre National de Recherche et de Formation sur le Paludisme, 01 BP 2208 Ouagadougou 01, Burkina Faso, Telephone: 226-50-324695, Fax: 226-50-310477. André Lin Ouédraogo, Petra Schneider, Marcel de Kruijf, Jan Peter Verhave, and Robert W. Sauerwein, Medical Microbiology Department 268, Radboud University Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands, Telephone: 31-24-3610577, Fax: 31-24-3614666..

Reprint requests: Robert W. Sauerwein, Medical Microbiology 268, Radboud University Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands.

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