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Exposure to Diverse Plasmodium falciparum Genotypes Shapes the Risk of Symptomatic Malaria in Incident and Persistent Infections: A Longitudinal Molecular Epidemiologic Study in Kenya.

Publication ,  Journal Article
Sumner, KM; Freedman, E; Mangeni, JN; Obala, AA; Abel, L; Edwards, JK; Emch, M; Meshnick, SR; Pence, BW; Prudhomme-O'Meara, W; Taylor, SM
Published in: Clin Infect Dis
October 5, 2021

BACKGROUND: Repeated exposure to malaria infections could protect against symptomatic progression as people develop adaptive immunity to infections acquired over time. METHODS: We investigated how new, recurrent, and persistent Plasmodium falciparum infections were associated with the odds of developing symptomatic compared with asymptomatic malaria. Using a 14-month longitudinal cohort in Western Kenya, we used amplicon deep sequencing of 2 polymorphic genes (pfama1 and pfcsp) to assess overlap of parasite genotypes (represented by haplotypes) acquired within an individual's successive infections. We hypothesized infections with novel haplotypes would increase the odds of symptomatic malaria. RESULTS: After excluding initial infections, we observed 534 asymptomatic and 88 symptomatic infections across 186 people. We detected 109 pfcsp haplotypes, and each infection was classified as harboring novel, recurrent, or persistent haplotypes. Incident infections with only new haplotypes had higher odds of symptomatic malaria when compared with infections with only recurrent haplotypes [odds ratio (OR): 3.24; 95% confidence interval (CI), 1.20-8.78], but infections with both new and recurrent haplotypes (OR: 0.64; 95% CI: 0.15-2.65) did not. Assessing persistent infections, those with mixed (persistent with new or recurrent) haplotypes (OR: 0.77; 95% CI: 0.21-2.75) had no association with symptomatic malaria compared with infections with only persistent haplotypes. Results were similar for pfama1. CONCLUSIONS: These results confirm that incident infections with only novel haplotypes were associated with increased odds of symptomatic malaria compared with infections with only recurrent haplotypes but this relationship was not seen when haplotypes persisted over time in consecutive infections.

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Published In

Clin Infect Dis

DOI

EISSN

1537-6591

Publication Date

October 5, 2021

Volume

73

Issue

7

Start / End Page

1176 / 1184

Location

United States

Related Subject Headings

  • Plasmodium falciparum
  • Microbiology
  • Malaria, Falciparum
  • Longitudinal Studies
  • Kenya
  • Humans
  • Genotype
  • Asymptomatic Infections
  • 3202 Clinical sciences
  • 11 Medical and Health Sciences
 

Citation

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Sumner, K. M., Freedman, E., Mangeni, J. N., Obala, A. A., Abel, L., Edwards, J. K., … Taylor, S. M. (2021). Exposure to Diverse Plasmodium falciparum Genotypes Shapes the Risk of Symptomatic Malaria in Incident and Persistent Infections: A Longitudinal Molecular Epidemiologic Study in Kenya. Clin Infect Dis, 73(7), 1176–1184. https://doi.org/10.1093/cid/ciab357
Sumner, Kelsey M., Elizabeth Freedman, Judith N. Mangeni, Andrew A. Obala, Lucy Abel, Jessie K. Edwards, Michael Emch, et al. “Exposure to Diverse Plasmodium falciparum Genotypes Shapes the Risk of Symptomatic Malaria in Incident and Persistent Infections: A Longitudinal Molecular Epidemiologic Study in Kenya.Clin Infect Dis 73, no. 7 (October 5, 2021): 1176–84. https://doi.org/10.1093/cid/ciab357.
Sumner, Kelsey M., et al. “Exposure to Diverse Plasmodium falciparum Genotypes Shapes the Risk of Symptomatic Malaria in Incident and Persistent Infections: A Longitudinal Molecular Epidemiologic Study in Kenya.Clin Infect Dis, vol. 73, no. 7, Oct. 2021, pp. 1176–84. Pubmed, doi:10.1093/cid/ciab357.
Sumner KM, Freedman E, Mangeni JN, Obala AA, Abel L, Edwards JK, Emch M, Meshnick SR, Pence BW, Prudhomme-O’Meara W, Taylor SM. Exposure to Diverse Plasmodium falciparum Genotypes Shapes the Risk of Symptomatic Malaria in Incident and Persistent Infections: A Longitudinal Molecular Epidemiologic Study in Kenya. Clin Infect Dis. 2021 Oct 5;73(7):1176–1184.
Journal cover image

Published In

Clin Infect Dis

DOI

EISSN

1537-6591

Publication Date

October 5, 2021

Volume

73

Issue

7

Start / End Page

1176 / 1184

Location

United States

Related Subject Headings

  • Plasmodium falciparum
  • Microbiology
  • Malaria, Falciparum
  • Longitudinal Studies
  • Kenya
  • Humans
  • Genotype
  • Asymptomatic Infections
  • 3202 Clinical sciences
  • 11 Medical and Health Sciences