ArticlePLoS neglected tropical diseases2022
Co-infection of the four major Plasmodium species: Effects on densities and gametocyte carriage.
Article in PLoS neglected tropical diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02143934 (Host and Parasites Factors Contributing to Risk of Plasmodium Re-infection and Morbidity in Elementary School Children in Maprik, East Sepik Province), which is not on this map. Cited by 19 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Host and Parasites Factors Contributing to Risk of Plasmodium Re-infection and Morbidity in Elementary School Children in Maprik, East Sepik Province
Who cites it
19 citing papers in PubMed, 22 citations in OpenAlex.
- Plasmodium vivax and Plasmodium falciparum mixed infections in human and mosquito hosts: The impact of multi-species infection on parasite densities and transmission to mosquitoes.PLoS neglected tropical diseases · 2026Article
- Seasonal Variation and Interspecies Dynamics Among Plasmodium falciparum and ovale Species in Bagamoyo, Tanzania.The Journal of infectious diseases · 2026Article
- Plasmodium malariae is an overlooked malaria parasite with emerging challenges.Communications medicine · 2026Review
- Mixed malaria infections: A critical review and Detect-Characterise-Act surveillance framework.Current research in parasitology & vector-borne diseases · 2026Review
- Epidemiology of ovale, vivax and falciparum malaria in the highlands of Cameroon: An integrated community survey of human infection and vector abundance.PLoS neglected tropical diseases · 2025Article
- Epidemiology of Relapsing and Falciparum Malaria in the Highlands of Cameroon: An Integrated Community Survey of Human Infection and Vector Abundance.medRxiv : the preprint server for health sciences · 2025Article
- Seasonal variation and interspecies dynamics amongmedRxiv : the preprint server for health sciences · 2025Article
- Plasmodium cynomolgi Infections Not Found in Microscopy-Diagnosed Malaria Cases across Sabah, Malaysia.The American journal of tropical medicine and hygiene · 2025Article
- Heterogeneous mosquito exposure increasesProceedings. Biological sciences · 2024Article
- Assessing the burden of submicroscopic Plasmodium infections in a pre-elimination malaria setting in sub-Saharan Africa, Guinea-Bissau.Malaria journal · 2024Article
- Real-time PCR for malaria diagnosis and identification of Plasmodium species in febrile patients in Cubal, Angola.Parasites & vectors · 2024Article
- Development of new real-time PCR assays for detection and species differentiation of Plasmodium ovale.PLoS neglected tropical diseases · 2024Article
- Evaluation of combination vaccines targeting transmission of Plasmodium falciparum and P. vivax.Vaccine · 2024Article
- Malaria Species Positivity Rates Among Symptomatic Individuals Across Regions of Differing Transmission Intensities in Mainland Tanzania.The Journal of infectious diseases · 2024Article
- Identification of conserved cross-species B-cell linear epitopes in human malaria: a subtractive proteomics and immuno-informatics approach targeting merozoite stage proteins.Frontiers in immunology · 2024Article
- Is qPCR always the most sensitive method for malaria diagnostic quality surveillance?Malaria journal · 2023Article
- A novel duplex qualitative real-time PCR assay for the detection and differentiation of Plasmodium ovale curtisi and Plasmodium ovale wallikeri malaria.medRxiv : the preprint server for health sciences · 2023Article
- Sensitive Detection of Asymptomatic and Symptomatic Malaria with Seven Novel Parasite-Specific LAMP Assays and Translation for Use at Point-of-Care.Microbiology spectrum · 2023Article
- Impact of the COVID-19 Pandemic on Malaria Control in Africa: A Preliminary Analysis.Tropical medicine and infectious disease · 2023Article
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 4 countries.
Funding
Abstract
backgroundCo-infection of the four major species of human malaria parasite Plasmodium falciparum (Pf), P. vivax (Pv), P. malariae (Pm), and P. ovale sp. (Po) is regularly observed, but there is limited understanding of between-species interactions. In particular, little is known about the effects of multiple Plasmodium species co-infections on gametocyte production.
methodsWe developed molecular assays for detecting asexual and gametocyte stages of Pf, Pv, Pm, and Po. This is the first description of molecular diagnostics for Pm and Po gametocytes. These assays were implemented in a unique epidemiological setting in Papua New Guinea with sympatric transmission of all four Plasmodium species permitting a comprehensive investigation of species interactions.
findingsThe observed frequency of Pf-Pv co-infection for asexual parasites (14.7%) was higher than expected from individual prevalence rates (23.8%Pf x 47.4%Pv = 11.3%). The observed frequency of co-infection with Pf and Pv gametocytes (4.6%) was higher than expected from individual prevalence rates (13.1%Pf x 28.2%Pv = 3.7%). The excess risk of co-infection was 1.38 (95% confidence interval (CI): 1.09, 1.67) for all parasites and 1.37 (95% CI: 0.95, 1.79) for gametocytes. This excess co-infection risk was partially attributable to malaria infections clustering in some villages. Pf-Pv-Pm triple infections were four times more frequent than expected by chance alone, which could not be fully explained by infections clustering in highly exposed individuals. The effect of co-infection on parasite density was analyzed by systematic comparison of all pairwise interactions. This revealed a significant 6.57-fold increase of Pm density when co-infected with Pf. Pm gametocytemia also increased with Pf co-infection.
conclusionsHeterogeneity in exposure to mosquitoes is a key epidemiological driver of Plasmodium co-infection. Among the four co-circulating parasites, Pm benefitted most from co-infection with other species. Beyond this, no general prevailing pattern of suppression or facilitation was identified in pairwise analysis of gametocytemia and parasitemia of the four species.
trial registrationThis trial is registered with ClinicalTrials.gov, Trial ID: NCT02143934.
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