Plasmodium falciparum gametocyte burden in a Tanzanian low transmission setting

Author:

Mulamba Charles1,Williams Chris2,Odufuwa Olukayode G.1,Kweyamba Prisca A.1,Lazaro Linda O.3,Chabo Muhamed S.1,Kamage Janeth J.1,Kreppel Katharina3,Olotu Ally I.1

Affiliation:

1. Ifakara Health Institute

2. Jenner Institute

3. Nelson Mandela African Institution of Science and Technology

Abstract

Abstract

Background Malaria transmission depends on the presence of gametocytes in the peripheral blood of infected human hosts. Understanding malaria infectious reservoirs enables transmission-blocking interventions to target the most important hosts for the disease. This study characterized the distribution of gametocyte carriage as a baseline for clinical evaluation of a Pfs25-based transmission-blocking vaccine candidate in Bagamoyo, Tanzania. Methods A malaria survey was conducted in five villages, between 2022 and 2023. A total of 467 asymptomatic participants; 192 children (5–12 years), 65 adolescents (13–17 years) and 210 adults (18–45 years), were enrolled. Malaria was detected using three methods; Rapid Diagnostic Tests, Light Microscopy, and Quantitative Polymerase Chain Reaction. Geometric mean of the gametocyte density, and weighted arithmetic mean of gametocytes sex ratio were estimated. Results Overall, 23.5% (110/467) of the participants tested positive for malaria parasites, with majority positives (> 92%) being Plasmodium falciparum. The overall gametocytaemia was 5.6%, with percentage positivity of 6.8% (13/192), 6.2% (4/65) 4.3% and (9/210), in children, adolescents and adults, respectively. The geometric mean gametocyte density (gametocytes/µL) was higher in adults (124.6) than in children (71.7) and adolescents (50.5). Regression analysis showed that gametocytes were more likely to be present among male participants than female participants [ORa: 2.79 (95% CI: 1.19–6.59) p = 0.019]. The gametocyte sex ratio in children and adult gametocyte carriers was similar but higher than in adolescents. Conclusion The observed gametocyte densities and distribution across age groups suggest the need for malaria transmission-blocking interventions to target all population, particularly in low transmission settings. The implication of targeting only children may leave residual malaria transmission and re-infection from the left-out groups.

Publisher

Springer Science and Business Media LLC

Reference48 articles.

1. World Health Organization. World malaria report 2020: 20 years of global progress and challenges. 2020.

2. World Health Organization. World malaria report 2021. 2021.

3. The Government of. Tanzania.National Malaria Strategic Plan 2014–2020. 2014.

4. World Health Organization. World Malaria report 2023.

5. World Health Organization. World malaria report 2022.

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