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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.
In this longitudinal study of an incident (new infections) and chronic (asymptomatic infections) cohort of Plasmodium falciparum infection in children in Burkina Faso, the authors show higher gametocyte production and mosquito infectivity in chronic infections.
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1 Centre National de Recherche et de Formation sur le Paludisme (CNRFP), Ouagadougou 01, Burkina Faso (GRID:grid.507461.1) (ISNI:0000 0004 0413 3193); Radboud University Medical Centre, Radboud Institute for Health Sciences and Radboud Center for Infectious Diseases, Nijmegen, The Netherlands (GRID:grid.10417.33) (ISNI:0000 0004 0444 9382)
2 MRC International Statistics and Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK (GRID:grid.8991.9) (ISNI:0000 0004 0425 469X)
3 London School of Hygiene and Tropical Medicine, Department of Immunology and Infection, London, UK (GRID:grid.8991.9) (ISNI:0000 0004 0425 469X)
4 Centre National de Recherche et de Formation sur le Paludisme (CNRFP), Ouagadougou 01, Burkina Faso (GRID:grid.507461.1) (ISNI:0000 0004 0413 3193)
5 Radboud University Medical Centre, Radboud Institute for Health Sciences and Radboud Center for Infectious Diseases, Nijmegen, The Netherlands (GRID:grid.10417.33) (ISNI:0000 0004 0444 9382)
6 University of California San Francisco, Department of Medicine, San Francisco, USA (GRID:grid.266102.1) (ISNI:0000 0001 2297 6811)
7 Wellcome Centre for Integrative Parasitology, University of Glasgow, Glasgow, UK (GRID:grid.8756.c) (ISNI:0000 0001 2193 314X)