1921
Volume 101, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

Multiplicity of infection (MOI), the number of unique parasite genotypes found in one infected individual, may contribute to the development of clinical malaria disease. However, the independent contribution of MOI and parasite density to clinical disease has not been well characterized. We conducted a two-year longitudinal cohort study of adults and children in a high-transmission setting in Malawi to test the hypothesis that increased MOI was independently associated with clinical disease, after accounting for parasite density. Of 1,062 episodes of infection, 477 (44.9%) were associated with symptoms. After controlling for repeated measures within an individual, key demographic factors, and parasite density, there was no association between MOI and clinical disease (OR = 1.02, 95% CI: 0.70–1.51). Although the limited ability to discern MOI in low-density asymptomatic infections may have impacted our results, we conclude that MOI is not an independent risk factor for clinical disease.

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References

  1. World Health Organization, 2018. World Malaria Report 2018. Geneva, Switzerland: WHO.
    [Google Scholar]
  2. Smith T, Felger I, Tanner M, Beck HP, 1999. Premunition in Plasmodium falciparum infection: insights from the epidemiology of multiple infections. Trans R Soc Trop Med Hyg 93: 5964.
    [Google Scholar]
  3. Rogier C, Commenges D, Trape JF, 1996. Evidence for an age-dependent pyrogenic threshold of Plasmodium falciparum parasitemia in highly endemic populations. Am J Trop Med Hyg 54: 613619.
    [Google Scholar]
  4. Buchwald AG et al., 2019. Clinical implications of asymptomatic Plasmodium falciparum infections in Malawi. Clin Infect Dis 68: 106112.
    [Google Scholar]
  5. Al-Yaman F, Genton B, Reeder JC, Anders RF, Smith T, Alpers MP, 1997. Reduced risk of clinical malaria in children infected with multiple clones of Plasmodium falciparum in a highly endemic area: a prospective community study. Trans R Soc Trop Med Hyg 91: 602605.
    [Google Scholar]
  6. Müller DA, Charlwood JD, Felger I, Ferreira C, do Rosario V, Smith T, 2001. Prospective risk of morbidity in relation to multiplicity of infection with Plasmodium falciparum in São Tomé. Acta Trop 78: 155162.
    [Google Scholar]
  7. Ofosu-Okyere A, Mackinnon MJ, Sowa MP, Koram KA, Nkrumah F, Osei YD, Hill WG, Wilson MD, Arnot DE, 2001. Novel Plasmodium falciparum clones and rising clone multiplicities are associated with the increase in malaria morbidity in Ghanaian children during the transition into the high transmission season. Parasitology 123: 113123.
    [Google Scholar]
  8. Zainabadi K, Adams M, Han ZY, Lwin HW, Han KT, Ouattara A, Thura S, Plowe CV, Nyunt MM, 2017. A novel method for extracting nucleic acids from dried blood spots for ultrasensitive detection of low-density Plasmodium falciparum and Plasmodium vivax infections. Malar J 16: 377.
    [Google Scholar]
  9. Wwarn, 2015. Molecular Testing for Malaria Standard Operating Procedure (SOP) msp1, msp2, and glurp PCR. Available at: https://www.wwarn.org/tools-resources/procedures/agarose-gel-electrophoresis-msp1-msp2-and-glurp. Accessed May 28, 2019.
    [Google Scholar]
  10. Wwarn, 2015. Agarose Gel Electrophoresis of msp1, msp2 and glurp v1.1. Available at: https://www.wwarn.org/tools-resources/procedures/agarose-gel-electrophoresis-msp1-msp2-and-glurp. Accessed May 28, 2019.
    [Google Scholar]
  11. Smith T, Schellenberg JA, Hayes R, 1994. Attributable fraction estimates and case definitions for malaria in endemic. Stat Med 13: 23452358.
    [Google Scholar]
  12. Contamin H, Fandeur T, Bonnefoy S, Skouri F, Ntoumi F, Mercereau-uijalon O, 1995. PCR typing of field isolates of Plasmodium falciparum. J Clinical Microbiol 33: 944951.
    [Google Scholar]
  13. Farnert A et al., 2001. Genotyping of Plasmodium falciparum infections by PCR: a comparative multicentre study. Trans R Soc Trop Med Hyg 95: 225232.
    [Google Scholar]
  14. Lerch A, Koepfli C, Hofmann NE, Kattenberg JH, Rosanas-Urgell A, Betuela I, Mueller I, Felger I, 2019. Longitudinal tracking and quantification of individual Plasmodium falciparum clones in complex infections. Sci Rep 9: 3333.
    [Google Scholar]
  15. Denise LD, Carlota D, Baird JK, 2009. Acquired immunity to malaria. Clin Microbiol Rev 22: 1336.
    [Google Scholar]
  16. Hviid L, 2005. Naturally acquired immunity to Plasmodium falciparum malaria in Africa. Acta Trop 95: 270275.
    [Google Scholar]
  17. Pinkevych M, Petravic J, Bereczky S, Rooth I, Farnert A, Davenport MP, 2015. Understanding the relationship between Plasmodium falciparum growth rate and multiplicity of infection. J Infect Dis 211: 11211127.
    [Google Scholar]
  18. Wright GJ, Rayner JC, 2014. Plasmodium falciparum erythrocyte invasion: combining function with immune evasion. PLoS Pathog 10: e1003943.
    [Google Scholar]
  19. Pacheco MA, Lopez-Perez M, Vallejo AF, Herrera S, Arévalo-Herrera M, Escalante AA, 2016. Multiplicity of infection and disease severity in Plasmodium vivax. PLoS Negl Trop Dis 10: e0004355.
    [Google Scholar]
  20. Bei AK et al., 2018. Dramatic changes in malaria population genetic complexity in Dielmo and Ndiop, Senegal, revealed using genomic surveillance. J Infect Dis 217: 622627.
    [Google Scholar]
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  • Received : 30 Jan 2019
  • Accepted : 22 Apr 2019
  • Published online : 17 Jun 2019
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