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Plasmodium vivax and Plasmodium falciparum infection dynamics: re-infections, recrudescences and relapses
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Plasmodium vivax and Plasmodium falciparum infection dynamics: re-infections, recrudescences and relapses
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Journal Article
Plasmodium vivax and Plasmodium falciparum infection dynamics: re-infections, recrudescences and relapses
2018
Overview
Background
In malaria endemic populations, complex patterns of
Plasmodium vivax
and
Plasmodium falciparum
blood-stage infection dynamics may be observed. Genotyping samples from longitudinal cohort studies for
merozoite surface protein
(
msp
) variants increases the information available in the data, allowing multiple infecting parasite clones in a single individual to be identified.
msp
genotyped samples from two longitudinal cohorts in Papua New Guinea (PNG) and Thailand were analysed using a statistical model where the times of acquisition and clearance of each clone in every individual were estimated using a process of data augmentation.
Results
For the populations analysed, the duration of blood-stage
P. falciparum
infection was estimated as 36 (95% Credible Interval (CrI): 29, 44) days in PNG, and 135 (95% CrI 94, 191) days in Thailand. Experiments on simulated data indicated that it was not possible to accurately estimate the duration of blood-stage
P. vivax
infections due to the lack of identifiability between a single blood-stage infection and multiple, sequential blood-stage infections caused by relapses. Despite this limitation, the method and data point towards short duration of blood-stage
P. vivax
infection with a lower bound of 24 days in PNG, and 29 days in Thailand. On an individual level,
P. vivax
recurrences cannot be definitively classified into re-infections, recrudescences or relapses, but a probabilistic relapse phenotype can be assigned to each
P. vivax
sample, allowing investigation of the association between epidemiological covariates and the incidence of relapses.
Conclusion
The statistical model developed here provides a useful new tool for in-depth analysis of malaria data from longitudinal cohort studies, and future application to data sets with multi-locus genotyping will allow more detailed investigation of infection dynamics.
Publisher
BioMed Central,BioMed Central Ltd,BMC
Subject
/ Adult
/ Aged
/ Analysis
/ Biomedical and Life Sciences
/ Child
/ Diseases
/ Female
/ Genotype
/ Humans
/ Infant
/ Malaria
/ Malaria, Falciparum - epidemiology
/ Malaria, Falciparum - parasitology
/ Malaria, Vivax - epidemiology
/ Malaria, Vivax - parasitology
/ Male
/ Papua New Guinea - epidemiology
/ Plasmodium falciparum - genetics
/ Plasmodium falciparum - physiology
/ Plasmodium vivax - physiology
/ Relapse
