Multiplicity of Asymptomatic Plasmodium falciparum Infections and Risk of Clinical Malaria: A Systematic Review and Pooled Analysis of Individual Participant Data.
Adolescent
Adult
Aged
Aged, 80 and over
Antigens, Protozoan
/ genetics
Asymptomatic Infections
/ epidemiology
Child
Child, Preschool
Female
Follow-Up Studies
Genotype
Humans
Incidence
Infant
Malaria, Falciparum
/ epidemiology
Male
Merozoite Surface Protein 1
/ genetics
Middle Aged
Plasmodium falciparum
/ genetics
Prospective Studies
Protozoan Proteins
/ genetics
Risk
Young Adult
Plasmodium falciparum
clones
immunity
malaria
multiplicity of infection
risk analyses
Journal
The Journal of infectious diseases
ISSN: 1537-6613
Titre abrégé: J Infect Dis
Pays: United States
ID NLM: 0413675
Informations de publication
Date de publication:
18 02 2020
18 02 2020
Historique:
received:
19
06
2019
accepted:
01
10
2019
pubmed:
5
10
2019
medline:
25
11
2020
entrez:
5
10
2019
Statut:
ppublish
Résumé
The malaria parasite Plasmodium falciparum holds an extensive genetic polymorphism. In this pooled analysis, we investigate how the multiplicity in asymptomatic P. falciparum infections-that is, the number of coinfecting clones-affects the subsequent risk of clinical malaria in populations living under different levels of transmission. A systematic search of the literature was performed to identify studies in which P. falciparum infections were genotyped in asymptomatic individuals who were followed up prospectively regarding the incidence of clinical malaria. Individual participant data were pooled from 15 studies (n = 3736 individuals). Multiclonal asymptomatic infections were associated with a somewhat increased subsequent risk of clinical malaria in the youngest children, followed by an initial declining risk with age irrespective of transmission intensity. At approximately 5 years of age, the risk continued the gradual decline with age in high-transmission settings. However, in older children in moderate-, low-, and seasonal-transmission settings, multiclonal infections were either not significantly associated with the risk of subsequent febrile malaria or were associated with an increased risk. The number of clones in asymptomatic P. falciparum infections is associated with different risks of subsequent clinical malaria depending on age and transmission intensity.
Sections du résumé
BACKGROUND
The malaria parasite Plasmodium falciparum holds an extensive genetic polymorphism. In this pooled analysis, we investigate how the multiplicity in asymptomatic P. falciparum infections-that is, the number of coinfecting clones-affects the subsequent risk of clinical malaria in populations living under different levels of transmission.
METHODS
A systematic search of the literature was performed to identify studies in which P. falciparum infections were genotyped in asymptomatic individuals who were followed up prospectively regarding the incidence of clinical malaria. Individual participant data were pooled from 15 studies (n = 3736 individuals).
RESULTS
Multiclonal asymptomatic infections were associated with a somewhat increased subsequent risk of clinical malaria in the youngest children, followed by an initial declining risk with age irrespective of transmission intensity. At approximately 5 years of age, the risk continued the gradual decline with age in high-transmission settings. However, in older children in moderate-, low-, and seasonal-transmission settings, multiclonal infections were either not significantly associated with the risk of subsequent febrile malaria or were associated with an increased risk.
CONCLUSIONS
The number of clones in asymptomatic P. falciparum infections is associated with different risks of subsequent clinical malaria depending on age and transmission intensity.
Identifiants
pubmed: 31585009
pii: 5581561
doi: 10.1093/infdis/jiz510
pmc: PMC7026891
doi:
Substances chimiques
Antigens, Protozoan
0
Merozoite Surface Protein 1
0
Protozoan Proteins
0
merozoite surface protein 2, Plasmodium
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
775-785Informations de copyright
© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America.
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