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Long-term asymptomatic carriage of Plasmodium falciparum protects from malaria attacks: a prospective study among Senegalese children.
Clin Infect Dis. 2008 Feb 15; 46(4):516-22.CI

Abstract

BACKGROUND

In areas of seasonal malaria transmission, long-term asymptomatic carriage of Plasmodium falciparum throughout the dry season has been primarily studied in terms of the parasites, and the clinical consequences of persistent parasite carriage are unknown.

METHODS

A prospective study was conducted in Senegal, from 2001 through 2003 among 1356 children living in areas where malaria is endemic, with seasonal transmission occurring from August through December. Cross-sectional parasitological measurements and detection of active malaria attacks were performed. A malaria attack was defined as an axillary temperature > or =37.5 degrees C, associated with a parasite density >2500 trophozoites/microL. Children harboring P. falciparum in June who did not have clinical signs were defined as asymptomatic carriers. The association of asymptomatic carriage with parasite densities and with the occurrence of malaria attacks during the rainy season were analyzed separately for the years 2002 and 2003, taking into account potential confounding covariates and use of antimalarial drugs.

RESULTS

The prevalence of asymptomatic carriage was 32% (332 of 1025 persons) in June 2002 and 23% (208 of 912 persons) in June 2003. Asymptomatic P. falciparum carriers had a significantly higher mean parasite density and a significantly lower probability of developing a malaria attack during the subsequent rainy season than did noncarriers (adjusted odds ratio in 2002, 0.56; P = .01; adjusted odds ratio in 2003, 0.50; P = .01).

CONCLUSIONS

These results suggest that in areas of seasonal transmission, asymptomatic carriage of P. falciparum may protect against clinical malaria. Further studies are needed to understand the immune effectors and host susceptibility that could be involved in this phenomenon.

Authors+Show Affiliations

Institut de Recherche pour Développement, UR010, Dakar, Sénégal. sylviamales@yahoo.frNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18199040

Citation

Males, Sylvia, et al. "Long-term Asymptomatic Carriage of Plasmodium Falciparum Protects From Malaria Attacks: a Prospective Study Among Senegalese Children." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 46, no. 4, 2008, pp. 516-22.
Males S, Gaye O, Garcia A. Long-term asymptomatic carriage of Plasmodium falciparum protects from malaria attacks: a prospective study among Senegalese children. Clin Infect Dis. 2008;46(4):516-22.
Males, S., Gaye, O., & Garcia, A. (2008). Long-term asymptomatic carriage of Plasmodium falciparum protects from malaria attacks: a prospective study among Senegalese children. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 46(4), 516-22. https://doi.org/10.1086/526529
Males S, Gaye O, Garcia A. Long-term Asymptomatic Carriage of Plasmodium Falciparum Protects From Malaria Attacks: a Prospective Study Among Senegalese Children. Clin Infect Dis. 2008 Feb 15;46(4):516-22. PubMed PMID: 18199040.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term asymptomatic carriage of Plasmodium falciparum protects from malaria attacks: a prospective study among Senegalese children. AU - Males,Sylvia, AU - Gaye,Oumar, AU - Garcia,André, PY - 2008/1/18/pubmed PY - 2008/2/6/medline PY - 2008/1/18/entrez SP - 516 EP - 22 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 46 IS - 4 N2 - BACKGROUND: In areas of seasonal malaria transmission, long-term asymptomatic carriage of Plasmodium falciparum throughout the dry season has been primarily studied in terms of the parasites, and the clinical consequences of persistent parasite carriage are unknown. METHODS: A prospective study was conducted in Senegal, from 2001 through 2003 among 1356 children living in areas where malaria is endemic, with seasonal transmission occurring from August through December. Cross-sectional parasitological measurements and detection of active malaria attacks were performed. A malaria attack was defined as an axillary temperature > or =37.5 degrees C, associated with a parasite density >2500 trophozoites/microL. Children harboring P. falciparum in June who did not have clinical signs were defined as asymptomatic carriers. The association of asymptomatic carriage with parasite densities and with the occurrence of malaria attacks during the rainy season were analyzed separately for the years 2002 and 2003, taking into account potential confounding covariates and use of antimalarial drugs. RESULTS: The prevalence of asymptomatic carriage was 32% (332 of 1025 persons) in June 2002 and 23% (208 of 912 persons) in June 2003. Asymptomatic P. falciparum carriers had a significantly higher mean parasite density and a significantly lower probability of developing a malaria attack during the subsequent rainy season than did noncarriers (adjusted odds ratio in 2002, 0.56; P = .01; adjusted odds ratio in 2003, 0.50; P = .01). CONCLUSIONS: These results suggest that in areas of seasonal transmission, asymptomatic carriage of P. falciparum may protect against clinical malaria. Further studies are needed to understand the immune effectors and host susceptibility that could be involved in this phenomenon. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/18199040/Long_term_asymptomatic_carriage_of_Plasmodium_falciparum_protects_from_malaria_attacks:_a_prospective_study_among_Senegalese_children_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1086/526529 DB - PRIME DP - Unbound Medicine ER -