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Asymptomatic Multiclonal Plasmodium falciparum Infections Carried Through the Dry Season Predict Protection Against Subsequent Clinical Malaria.
J Infect Dis. 2015 Aug 15; 212(4):608-16.JI

Abstract

BACKGROUND

Immunity to the antigenically diverse parasite Plasmodium falciparum is acquired gradually after repeated exposure. Studies in areas of high malaria transmission have shown that asymptomatic individuals infected with multiclonal infections are at reduced risk of febrile malaria during follow-up.

METHODS

We assessed the relationship between the genetic diversity of clones in P. falciparum infections that persist through the dry season and the subsequent risk of febrile malaria in 225 individuals aged 2-25 years in Mali, where the 6-month malaria and dry seasons are sharply demarcated. Polymerase chain reaction-based genotyping of the highly polymorphic merozoite surface protein 2 gene was performed on blood samples collected at 5 cross-sectional surveys.

RESULTS

In an age-adjusted analysis, individuals with multiclonal P. falciparum infections before the rainy season were at reduced risk of febrile malaria, compared with individuals who were uninfected (hazard ratio [HR], 0.28; 95% confidence interval [CI], .11-.69). In contrast, there was no significant association between risk of malaria and having 1 clone at baseline (HR, 0.71; 95% CI, .36-1.40).

CONCLUSIONS

The results suggest that persistent multiclonal infections carried through the dry season contribute to protection against subsequent febrile malaria, possibly by maintaining protective immune responses that depend on ongoing parasite infection.

Links

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Authors+Show Affiliations

Sondén K
Unit of Infectious Diseases, Department of Medicine Solna.
Doumbo S
Mali International Center of Excellence in Research, University of Sciences, Technique, and Technology of Bamako.
Hammar U
Unit of Biostatistics, Department of Epidemiology, Institute for Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Vafa Homann M
Unit of Infectious Diseases, Department of Medicine Solna.
Ongoiba A
Unit of Biostatistics, Department of Epidemiology, Institute for Environmental Medicine, Karolinska Institutet, Stockholm, Sweden Mali International Center of Excellence in Research, University of Sciences, Technique, and Technology of Bamako.
Traoré B
Mali International Center of Excellence in Research, University of Sciences, Technique, and Technology of Bamako.
Bottai M
Unit of Biostatistics, Department of Epidemiology, Institute for Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Crompton PD
Laboratory of Immunogenetics, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland.
Färnert A
Unit of Infectious Diseases, Department of Medicine Solna.

MeSH

AdolescentAdultAgingAntigens, ProtozoanChildChild, PreschoolCohort StudiesFemaleGenotypeHumansMalaria, FalciparumMalePlasmodium falciparumProtozoan ProteinsRainSeasonsTime FactorsYoung Adult

Pub Type(s)

Journal Article
Research Support, N.I.H., Intramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25712968

Citation

Sondén, Klara, et al. "Asymptomatic Multiclonal Plasmodium Falciparum Infections Carried Through the Dry Season Predict Protection Against Subsequent Clinical Malaria." The Journal of Infectious Diseases, vol. 212, no. 4, 2015, pp. 608-16.
Sondén K, Doumbo S, Hammar U, et al. Asymptomatic Multiclonal Plasmodium falciparum Infections Carried Through the Dry Season Predict Protection Against Subsequent Clinical Malaria. J Infect Dis. 2015;212(4):608-16.
Sondén, K., Doumbo, S., Hammar, U., Vafa Homann, M., Ongoiba, A., Traoré, B., Bottai, M., Crompton, P. D., & Färnert, A. (2015). Asymptomatic Multiclonal Plasmodium falciparum Infections Carried Through the Dry Season Predict Protection Against Subsequent Clinical Malaria. The Journal of Infectious Diseases, 212(4), 608-16. https://doi.org/10.1093/infdis/jiv088
Sondén K, et al. Asymptomatic Multiclonal Plasmodium Falciparum Infections Carried Through the Dry Season Predict Protection Against Subsequent Clinical Malaria. J Infect Dis. 2015 Aug 15;212(4):608-16. PubMed PMID: 25712968.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Asymptomatic Multiclonal Plasmodium falciparum Infections Carried Through the Dry Season Predict Protection Against Subsequent Clinical Malaria. AU - Sondén,Klara, AU - Doumbo,Safiatou, AU - Hammar,Ulf, AU - Vafa Homann,Manijeh, AU - Ongoiba,Aissata, AU - Traoré,Boubacar, AU - Bottai,Matteo, AU - Crompton,Peter D, AU - Färnert,Anna, Y1 - 2015/02/23/ PY - 2014/10/30/received PY - 2015/02/06/accepted PY - 2015/2/26/entrez PY - 2015/2/26/pubmed PY - 2015/10/13/medline KW - P. falciparum KW - children KW - genotyping KW - immunity KW - malaria KW - msp2 SP - 608 EP - 16 JF - The Journal of infectious diseases JO - J Infect Dis VL - 212 IS - 4 N2 - BACKGROUND: Immunity to the antigenically diverse parasite Plasmodium falciparum is acquired gradually after repeated exposure. Studies in areas of high malaria transmission have shown that asymptomatic individuals infected with multiclonal infections are at reduced risk of febrile malaria during follow-up. METHODS: We assessed the relationship between the genetic diversity of clones in P. falciparum infections that persist through the dry season and the subsequent risk of febrile malaria in 225 individuals aged 2-25 years in Mali, where the 6-month malaria and dry seasons are sharply demarcated. Polymerase chain reaction-based genotyping of the highly polymorphic merozoite surface protein 2 gene was performed on blood samples collected at 5 cross-sectional surveys. RESULTS: In an age-adjusted analysis, individuals with multiclonal P. falciparum infections before the rainy season were at reduced risk of febrile malaria, compared with individuals who were uninfected (hazard ratio [HR], 0.28; 95% confidence interval [CI], .11-.69). In contrast, there was no significant association between risk of malaria and having 1 clone at baseline (HR, 0.71; 95% CI, .36-1.40). CONCLUSIONS: The results suggest that persistent multiclonal infections carried through the dry season contribute to protection against subsequent febrile malaria, possibly by maintaining protective immune responses that depend on ongoing parasite infection. SN - 1537-6613 UR - https://www.unboundmedicine.com/medline/citation/25712968/Asymptomatic_Multiclonal_Plasmodium_falciparum_Infections_Carried_Through_the_Dry_Season_Predict_Protection_Against_Subsequent_Clinical_Malaria_ L2 - https://academic.oup.com/jid/article-lookup/doi/10.1093/infdis/jiv088 DB - PRIME DP - Unbound Medicine ER -