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The prevalence of submicroscopic Plasmodium falciparum gametocyte carriage and multiplicity of infection in children, pregnant women and adults in a low malaria transmission area in Southern Ghana
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The prevalence of submicroscopic Plasmodium falciparum gametocyte carriage and multiplicity of infection in children, pregnant women and adults in a low malaria transmission area in Southern Ghana
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The prevalence of submicroscopic Plasmodium falciparum gametocyte carriage and multiplicity of infection in children, pregnant women and adults in a low malaria transmission area in Southern Ghana
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Journal Article
The prevalence of submicroscopic Plasmodium falciparum gametocyte carriage and multiplicity of infection in children, pregnant women and adults in a low malaria transmission area in Southern Ghana
2018
Overview
Background
The gametocyte stage of
Plasmodium falciparum
is considered an important target for disrupting malaria transmission. Indications are that various demographic groups, such as children and pregnant women may differ in risk of harbouring gametocytes, which may be crucial for targeted control. In this study, the relationship between the prevalence and multiplicity of
P. falciparum
, asexual parasite infections and gametocytaemia was assessed in three different demographic groups in an area of southern Ghana with low malaria endemicity. Levels of antibody responses to
Pf
s230 were also assessed as a proxy for the presence of gametocytes.
Methods
The study involved multiple cross-sectional sampling of children (N = 184, aged 2–15 years), male and non-pregnant female adults (N = 154, aged 16–65 years) and pregnant women (N = 125, aged 18–45 years) from Asutsuare in the Shai Osudoku District of Greater Accra Region in Ghana. Asexual parasitaemia was detected by microscopy and PCR, and gametocytaemia was assessed by
Pf
s25-real time PCR. Multiclonal
P. falciparum
infections were estimated by
msp2
genotyping and an indirect ELISA was used to measure plasma IgG antibodies to
Pf
s230 antigen.
Results
Overall, children and pregnant women had higher prevalence of submicroscopic gametocytes (39.5% and 29.7%, respectively) compared to adults (17.4%). Multiplicity of infection observed amongst children (3.1) and pregnant women (3.9) were found to be significantly higher (P = 0.006) compared with adults (2.7). Risk of gametocyte carriage was higher in individuals infected with
P. falciparum
having both
Pf
msp2 3D7 and FC27 parasite types (OR = 5.92, 95% CI 1.56–22.54, P = 0.009) compared with those infected with only 3D7 or FC27 parasite types. In agreement with the parasite prevalence data, anti-
Pfs
230 antibody levels were lower in gametocyte positive adults (β = − 0.57, 95% CI − 0.81, − 0.34, P < 0.001) compared to children.
Conclusions
These findings suggest that children and pregnant women are particularly important as
P. falciparum
submicroscopic gametocyte reservoirs and represent important focus groups for control interventions. The number of clones increased in individuals carrying gametocytes compared to those who did not carry gametocytes. The higher anti-gametocyte antibody levels in children suggests recent exposure and may be a marker of gametocyte carriage.
