Microscopic and submicroscopic asymptomatic Plasmodium falciparum infections in Ghanaian children and protection against febrile malaria
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Microscopic and submicroscopic asymptomatic Plasmodium falciparum infections in Ghanaian children and protection against febrile malaria. / Adu, Bright; Issahaque, Quratul-Ain; Sarkodie-Addo, Tracy; Kumordjie, Selassie; Kyei-Baafour, Eric; Sinclear, Caleb K; Eyia-Ampah, Sophia; Owusu-Yeboa, Eunice; Theisen, Michael; Dodoo, Daniel.
In: Infection and Immunity, Vol. 88, No. 10, e00125-20, 2020.Research output: Contribution to journal › Journal article › Research › peer-review
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T1 - Microscopic and submicroscopic asymptomatic Plasmodium falciparum infections in Ghanaian children and protection against febrile malaria
AU - Adu, Bright
AU - Issahaque, Quratul-Ain
AU - Sarkodie-Addo, Tracy
AU - Kumordjie, Selassie
AU - Kyei-Baafour, Eric
AU - Sinclear, Caleb K
AU - Eyia-Ampah, Sophia
AU - Owusu-Yeboa, Eunice
AU - Theisen, Michael
AU - Dodoo, Daniel
N1 - Copyright © 2020 Adu et al.
PY - 2020
Y1 - 2020
N2 - Naturally acquired immunity to Plasmodium falciparum malaria is thought to be nonsterile and sustained by persistence of low-level parasitemia. This study assessed the association between baseline microscopic and submicroscopic asymptomatic P. falciparum infections and antimalarial antibody levels and whether these parasitemia modify protective associations between antibody levels and malaria in Ghanaian children. Healthy children (N = 973, aged 0.5 to 12 years) were recruited into a 50-week longitudinal malaria cohort study from January 2016 to January 2017. Baseline asymptomatic parasitemia were determined by microscopy (microscopic parasitemia) and PCR (submicroscopic parasitemia), and antibody levels against crude schizont antigens were measured by enzyme-limited immunosorbent assay (ELISA). Antibody levels, parasite diversity, and risk of malaria in the ensuing transmission season were compared among children who had baseline asymptomatic microscopic or submicroscopic or no P. falciparum infections. Of the 99 asymptomatic baseline infections, 46 (46.5%) were microscopic and 53 (53.5%), submicroscopic. Cox regression analysis adjusting for age group, sex and community found a strong association between both baseline microscopic (hazard ratio [HR] = 0.36, 95% confidence interval [95% CI] = 0.21 to 0.63; P < 0.001) and submicroscopic (HR = 0.22, 95% CI = 0.11 to 0.44; P < 0.001) asymptomatic parasitemia and a reduced risk of febrile malaria compared to those who were uninfected at baseline. Baseline asymptomatic submicroscopic parasitemia had a significant effect on associations between antischizont antibodies and protection against febrile malaria (P < 0.001; likelihood ratio test). The study found both baseline P. falciparum asymptomatic microscopic and more strongly submicroscopic infections to be associated with protection against febrile malaria in the ensuing transmission season. This could have important implications for malaria seroepidemiological studies and vaccine trials.
AB - Naturally acquired immunity to Plasmodium falciparum malaria is thought to be nonsterile and sustained by persistence of low-level parasitemia. This study assessed the association between baseline microscopic and submicroscopic asymptomatic P. falciparum infections and antimalarial antibody levels and whether these parasitemia modify protective associations between antibody levels and malaria in Ghanaian children. Healthy children (N = 973, aged 0.5 to 12 years) were recruited into a 50-week longitudinal malaria cohort study from January 2016 to January 2017. Baseline asymptomatic parasitemia were determined by microscopy (microscopic parasitemia) and PCR (submicroscopic parasitemia), and antibody levels against crude schizont antigens were measured by enzyme-limited immunosorbent assay (ELISA). Antibody levels, parasite diversity, and risk of malaria in the ensuing transmission season were compared among children who had baseline asymptomatic microscopic or submicroscopic or no P. falciparum infections. Of the 99 asymptomatic baseline infections, 46 (46.5%) were microscopic and 53 (53.5%), submicroscopic. Cox regression analysis adjusting for age group, sex and community found a strong association between both baseline microscopic (hazard ratio [HR] = 0.36, 95% confidence interval [95% CI] = 0.21 to 0.63; P < 0.001) and submicroscopic (HR = 0.22, 95% CI = 0.11 to 0.44; P < 0.001) asymptomatic parasitemia and a reduced risk of febrile malaria compared to those who were uninfected at baseline. Baseline asymptomatic submicroscopic parasitemia had a significant effect on associations between antischizont antibodies and protection against febrile malaria (P < 0.001; likelihood ratio test). The study found both baseline P. falciparum asymptomatic microscopic and more strongly submicroscopic infections to be associated with protection against febrile malaria in the ensuing transmission season. This could have important implications for malaria seroepidemiological studies and vaccine trials.
U2 - 10.1128/IAI.00125-20
DO - 10.1128/IAI.00125-20
M3 - Journal article
C2 - 32719157
VL - 88
JO - Infection and Immunity
JF - Infection and Immunity
SN - 0019-9567
IS - 10
M1 - e00125-20
ER -
ID: 248737298