ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
Exposure to Diverse Plasmodium falciparum Genotypes Shapes the Risk of Symptomatic Malaria in Incident and Persistent Infections: A Longitudinal Molecular Epidemiologic Study in Kenya.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 14 citations in OpenAlex.
- Genetic polymorphism ofFrontiers in parasitology · 2025Article
- Plasmodium falciparum genetic diversity and multiplicity of infection among asymptomatic and symptomatic malaria-infected individuals in Uganda.Tropical medicine and health · 2024Article
- Microheterogeneity of Transmission Shapes Submicroscopic Malaria Carriage in Coastal Tanzania.The Journal of infectious diseases · 2024Article
- Asymptomatic Low-Density Plasmodium falciparum Infections: Parasites Under the Host's Immune Radar?The Journal of infectious diseases · 2024Review
- Risk of Malaria Following Untreated Subpatent Plasmodium falciparum Infections: Results Over 4 Years From a Cohort in a High-Transmission Area in Western Kenya.The Journal of infectious diseases · 2024Article
- High Prevalence of PolyclonalTropical medicine and infectious disease · 2023Article
- Symptomatic malaria enhances protection from reinfection with homologous Plasmodium falciparum parasites.PLoS pathogens · 2023Article
- Symptomatic malaria enhances protection from reinfection with homologousmedRxiv : the preprint server for health sciences · 2023Article
- Exploring how space, time, and sampling impact our ability to measure genetic structure acrossFrontiers in epidemiology · 2023Article
- The role of naturally acquired antimalarial antibodies in subclinical Plasmodium spp. infection.Journal of leukocyte biology · 2022Review
- Impact of asymptomaticeLife · 2021Article
Corrections and comments
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Authors and funding
11 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundRepeated exposure to malaria infections could protect against symptomatic progression as people develop adaptive immunity to infections acquired over time.
methodsWe 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.
resultsAfter 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.
conclusionsThese 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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