The complex relationship of exposure to new Plasmodium infections and incidence of clinical malaria in Papua New Guinea
- Author(s)
- Hofmann, NE; Karl, S; Wampfler, R; Kiniboro, B; Teliki, A; Iga, J; Waltmann, A; Betuela, I; Felger, I; Robinson, LJ; Mueller, I;
- Journal Title
- Elife
- Publication Type
- Journal Article
- Abstract
- The molecular force of blood-stage infection (molFOB) is a quantitative surrogate metric for malaria transmission at population level and for exposure at individual level. Relationships between molFOB, parasite prevalence and clinical incidence were assessed in a treatment-to-reinfection cohort, where P.vivax (Pv) hypnozoites were eliminated in half the children by primaquine (PQ). Discounting relapses, children acquired equal numbers of new P. falciparum (Pf) and Pv blood-stage infections/year (Pf-molFOB=0-18, Pv-molFOB=0-23) resulting in comparable spatial and temporal patterns in incidence and prevalence of infections. Including relapses, Pv-molFOB increased >3-fold (relative to PQ-treated children) showing greater heterogeneity at individual (Pv-molFOB=0-36) and village levels. Pf- and Pv-molFOB were strongly associated with clinical episode risk. Yearly Pf clinical incidence rate (IR=0.28) was higher than for Pv (IR=0.12) despite lower Pf-molFOB. These relationships between molFOB, clinical incidence and parasite prevalence reveal a comparable decline in Pf and Pv transmission that is normally hidden by the high burden of Pv relapses.
- Publisher
- eLIFE
- Research Division(s)
- Population Health And Immunity
- PubMed ID
- 28862132
- Publisher's Version
- https://doi.org/10.7554/eLife.23708
- NHMRC Grants
- NHMRC/1043345,
- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2017-09-06 11:18:08
Last Modified: 2017-09-06 12:59:27