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

Aissata Barry; John Bradley ORCID logo; Will Stone ORCID logo; Moussa W Guelbeogo; Kjerstin Lanke; Alphonse Ouedraogo; Issiaka Soulama ORCID logo; Issa Nébié; Samuel S Serme; Lynn Grignard ORCID logo; +14 more... Catriona Patterson ORCID logo; Lindsey Wu; Jessica J Briggs ORCID logo; Owen Janson; Shehu S Awandu; Mireille Ouedraogo; Casimire W Tarama ORCID logo; Désiré Kargougou; Soumanaba Zongo; Sodiomon B Sirima; Matthias Marti ORCID logo; Chris Drakeley ORCID logo; Alfred B Tiono; Teun Bousema; (2020) Higher gametocyte production and mosquito infectivity in chronic compared to incident Plasmodium falciparum infections. Nature communications, 12 (1). 2443-. ISSN 2041-1723 DOI: 10.1038/s41467-021-22573-7
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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.


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