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J Infect Dis. 2016 Jan 1;213(1):90-9. doi: 10.1093/infdis/jiv370. Epub 2015 Jul 3.

Dynamics of the Human Infectious Reservoir for Malaria Determined by Mosquito Feeding Assays and Ultrasensitive Malaria Diagnosis in Burkina Faso.

Author information

1
Institute for Disease Modeling, Bellevue, Washington Département de Sciences Biomédicales, Centre National de Recherche et de Formation sur le Paludisme.
2
Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, United Kingdom.
3
Département de Sciences Biomédicales, Centre National de Recherche et de Formation sur le Paludisme Université de Ouagadougou.
4
Institute for Disease Modeling, Bellevue, Washington.
5
Département de Sciences Biomédicales, Centre National de Recherche et de Formation sur le Paludisme.
6
Département de Sciences Biomédicales, Centre National de Recherche et de Formation sur le Paludisme Africa Indoor Residual Spraying, Abt Associates, Madagascar.
7
Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands.
8
Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands Institut de Recherche pour le Développement, Mère et Enfant Face aux Infections Tropicales Faculté de Pharmacie, Sorbonne Paris Cité, Université Paris Descartes, France.
9
Département de Sciences Biomédicales, Centre National de Recherche et de Formation sur le Paludisme Ministère de la Santé, Ouagadougou, Burkina Faso.
10
Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, United Kingdom Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands.

Abstract

BACKGROUND:

Plasmodium falciparum gametocytes are essential for malaria transmission. Malaria control measures that aim at reducing transmission require an accurate characterization of the human infectious reservoir.

METHODS:

We longitudinally determined human infectiousness to mosquitoes and P. falciparum carriage by an ultrasensitive RNA-based diagnostics in 130 randomly selected inhabitants of an endemic area.

RESULTS:

At least 1 mosquito was infected by 32.6% (100 of 307) of the blood samples; in total, 7.6% of mosquitoes (916 of 12 079) were infected. The proportion of infectious individuals and infected mosquitoes were negatively associated with age and positively with asexual parasites (P < .001). Human infectiousness was higher at the start of the wet season and subsequently declined at the peak of the wet season (adjusted odds ratio, 0.52; P = .06) and in the dry season (0.23; P < .001). Overall, microscopy-negative individuals were responsible for 28.7% of infectious individuals (25 of 87) and 17.0% of mosquito infections (145 of 855).

CONCLUSIONS:

Our study reveals that the infectious reservoir peaks at the start of the wet season, with prominent roles for infections in children and submicroscopic infections. These findings have important consequences for strategies and the timing of interventions, which need to include submicroscopic infections and be implemented in the dry season.

KEYWORDS:

Burkina Faso; QT-NASBA; dynamics; falciparum; feeding; gametocyte; malaria; mosquito; reservoir; season

PMID:
26142435
DOI:
10.1093/infdis/jiv370
[Indexed for MEDLINE]

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