High Plasmodium falciparum longitudinal prevalence is associated with high multiclonality and reduced clinical malaria risk in a seasonal transmission area of Mali.

The effects of persistent Plasmodium falciparum (Pf) infection and multiclonality on subsequent risk of clinical malaria have been reported, but the relationship between these 2 parameters and their relative impacts on the clinical outcome of infection are not understood. A longitudinal cohort study...

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Main Authors: Yaw Adomako-Ankomah, Matthew S Chenoweth, Katelyn Durfee, Saibou Doumbia, Drissa Konate, Mory Doumbouya, Abdoul S Keita, Daria Nikolaeva, Gregory S Tullo, Jennifer M Anderson, Rick M Fairhurst, Rachel Daniels, Sarah K Volkman, Mahamadou Diakite, Kazutoyo Miura, Carole A Long
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2017-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0170948&type=printable
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author Yaw Adomako-Ankomah
Matthew S Chenoweth
Katelyn Durfee
Saibou Doumbia
Drissa Konate
Mory Doumbouya
Abdoul S Keita
Daria Nikolaeva
Gregory S Tullo
Jennifer M Anderson
Rick M Fairhurst
Rachel Daniels
Sarah K Volkman
Mahamadou Diakite
Kazutoyo Miura
Carole A Long
author_facet Yaw Adomako-Ankomah
Matthew S Chenoweth
Katelyn Durfee
Saibou Doumbia
Drissa Konate
Mory Doumbouya
Abdoul S Keita
Daria Nikolaeva
Gregory S Tullo
Jennifer M Anderson
Rick M Fairhurst
Rachel Daniels
Sarah K Volkman
Mahamadou Diakite
Kazutoyo Miura
Carole A Long
author_sort Yaw Adomako-Ankomah
collection DOAJ
description The effects of persistent Plasmodium falciparum (Pf) infection and multiclonality on subsequent risk of clinical malaria have been reported, but the relationship between these 2 parameters and their relative impacts on the clinical outcome of infection are not understood. A longitudinal cohort study was conducted in a seasonal and high-transmission area of Mali, in which 500 subjects aged 1-65 years were followed for 1 year. Blood samples were collected every 2 weeks, and incident malaria cases were diagnosed and treated. Pf infection in each individual at each time point was assessed by species-specific nested-PCR, and Pf longitudinal prevalence per person (PfLP, proportion of Pf-positive samples over 1 year) was calculated. Multiclonality of Pf infection was measured using a 24-SNP DNA barcoding assay at 4 time-points (two in wet season, and two in dry season) over one year. PfLP was positively correlated with multiclonality at each time point (all r≥0.36; all P≤0.011). When host factors (e.g., age, gender), PfLP, and multiclonality (at the beginning of the transmission season) were analyzed together, only increasing age and high PfLP were associated with reduced clinical malaria occurrence or reduced number of malaria episodes (for both outcomes, P<0.001 for age, and P = 0.005 for PfLP). When age, PfLP and baseline Pf positivity were analyzed together, the effect of high PfLP remained significant even after adjusting for the other two factors (P = 0.001 for malaria occurrence and P<0.001 for number of episodes). In addition to host age and baseline Pf positivity, both of which have been reported as important modifiers of clinical malaria risk, our results demonstrate that persistent parasite carriage, but not baseline multiclonality, is associated with reduced risk of clinical disease in this population. Our study emphasizes the importance of considering repeated parasite exposure in future studies that evaluate clinical malaria risk.
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spelling doaj-art-51a4f5f62da64da5b7028fd1f8df7ecc2025-08-20T02:03:54ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01122e017094810.1371/journal.pone.0170948High Plasmodium falciparum longitudinal prevalence is associated with high multiclonality and reduced clinical malaria risk in a seasonal transmission area of Mali.Yaw Adomako-AnkomahMatthew S ChenowethKatelyn DurfeeSaibou DoumbiaDrissa KonateMory DoumbouyaAbdoul S KeitaDaria NikolaevaGregory S TulloJennifer M AndersonRick M FairhurstRachel DanielsSarah K VolkmanMahamadou DiakiteKazutoyo MiuraCarole A LongThe effects of persistent Plasmodium falciparum (Pf) infection and multiclonality on subsequent risk of clinical malaria have been reported, but the relationship between these 2 parameters and their relative impacts on the clinical outcome of infection are not understood. A longitudinal cohort study was conducted in a seasonal and high-transmission area of Mali, in which 500 subjects aged 1-65 years were followed for 1 year. Blood samples were collected every 2 weeks, and incident malaria cases were diagnosed and treated. Pf infection in each individual at each time point was assessed by species-specific nested-PCR, and Pf longitudinal prevalence per person (PfLP, proportion of Pf-positive samples over 1 year) was calculated. Multiclonality of Pf infection was measured using a 24-SNP DNA barcoding assay at 4 time-points (two in wet season, and two in dry season) over one year. PfLP was positively correlated with multiclonality at each time point (all r≥0.36; all P≤0.011). When host factors (e.g., age, gender), PfLP, and multiclonality (at the beginning of the transmission season) were analyzed together, only increasing age and high PfLP were associated with reduced clinical malaria occurrence or reduced number of malaria episodes (for both outcomes, P<0.001 for age, and P = 0.005 for PfLP). When age, PfLP and baseline Pf positivity were analyzed together, the effect of high PfLP remained significant even after adjusting for the other two factors (P = 0.001 for malaria occurrence and P<0.001 for number of episodes). In addition to host age and baseline Pf positivity, both of which have been reported as important modifiers of clinical malaria risk, our results demonstrate that persistent parasite carriage, but not baseline multiclonality, is associated with reduced risk of clinical disease in this population. Our study emphasizes the importance of considering repeated parasite exposure in future studies that evaluate clinical malaria risk.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0170948&type=printable
spellingShingle Yaw Adomako-Ankomah
Matthew S Chenoweth
Katelyn Durfee
Saibou Doumbia
Drissa Konate
Mory Doumbouya
Abdoul S Keita
Daria Nikolaeva
Gregory S Tullo
Jennifer M Anderson
Rick M Fairhurst
Rachel Daniels
Sarah K Volkman
Mahamadou Diakite
Kazutoyo Miura
Carole A Long
High Plasmodium falciparum longitudinal prevalence is associated with high multiclonality and reduced clinical malaria risk in a seasonal transmission area of Mali.
PLoS ONE
title High Plasmodium falciparum longitudinal prevalence is associated with high multiclonality and reduced clinical malaria risk in a seasonal transmission area of Mali.
title_full High Plasmodium falciparum longitudinal prevalence is associated with high multiclonality and reduced clinical malaria risk in a seasonal transmission area of Mali.
title_fullStr High Plasmodium falciparum longitudinal prevalence is associated with high multiclonality and reduced clinical malaria risk in a seasonal transmission area of Mali.
title_full_unstemmed High Plasmodium falciparum longitudinal prevalence is associated with high multiclonality and reduced clinical malaria risk in a seasonal transmission area of Mali.
title_short High Plasmodium falciparum longitudinal prevalence is associated with high multiclonality and reduced clinical malaria risk in a seasonal transmission area of Mali.
title_sort high plasmodium falciparum longitudinal prevalence is associated with high multiclonality and reduced clinical malaria risk in a seasonal transmission area of mali
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0170948&type=printable
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