The complex relationship of exposure to new Plasmodium infections and incidence of clinical malaria in Papua New Guinea
Hofmann, Natalie, Karl, Stephan, Wampfler, Rahel, Kiniboro, Benson, Iga, Jonah, Waltmann, Andreea, Betuela, Inoni, Felger, Ingrid, Robinson, Leanne J., and Meuller, Ivo (2017) The complex relationship of exposure to new Plasmodium infections and incidence of clinical malaria in Papua New Guinea. eLife, 6. e23708.
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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.
| Item ID: | 70955 |
|---|---|
| Item Type: | Article (Research - C1) |
| ISSN: | 2050-084X |
| Copyright Information: | Copyright Hofmann et al. This article is distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use and redistribution provided that the original author and source are credited. |
| Funders: | National Health and Medical Research Council of Australia (NHMRC) |
| Projects and Grants: | NHMRC Early Career Fellowship #1052760, NHRMC Project Grant #1021544, NHMRC Early Career Fellowship #1016443, NHMRC Senior Research Fellowship #1043345 |
| Date Deposited: | 01 Dec 2021 01:58 |
| FoR Codes: | 42 HEALTH SCIENCES > 4202 Epidemiology > 420204 Epidemiological methods @ 100% |
| SEO Codes: | 20 HEALTH > 2004 Public health (excl. specific population health) > 200404 Disease distribution and transmission (incl. surveillance and response) @ 100% |
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