Dynamics of asymptomatic Plasmodium falciparum and Plasmodium vivax infections and their infectiousness to mosquitoes in a low transmission setting of Ethiopia: a longitudinal observational study

Int J Infect Dis. 2024 Jun:143:107010. doi: 10.1016/j.ijid.2024.107010. Epub 2024 Mar 14.

Abstract

Objective: A 15-month longitudinal study was conducted to determine the duration and infectivity of asymptomatic qPCR-detected Plasmodium falciparum and Plasmodium vivax infections in Ethiopia.

Method: Total parasite and gametocyte kinetics were determined by molecular methods; infectivity to Anopheles arabiensis mosquitoes by repeated membrane feeding assays. Infectivity results were contrasted with passively recruited symptomatic malaria cases.

Results: For P. falciparum and P. vivax infections detected at enrolment, median durations of infection were 37 days (95% confidence interval [CI], 15-93) and 60 days (95% CI, 18-213), respectively. P. falciparum and P. vivax parasite densities declined over the course of infections. From 47 feeding assays on 22 asymptomatic P. falciparum infections, 6.4% (3/47) were infectious and these infected 1.8% (29/1579) of mosquitoes. No transmission was observed in feeding assays on asymptomatic P. vivax mono-infections (0/56); one mixed-species infection was highly infectious. Among the symptomatic cases, 4.3% (2/47) of P. falciparum and 73.3% (53/86) of P. vivax patients were infectious to mosquitoes.

Conclusion: The majority of asymptomatic infections were of short duration and low parasite density. Only a minority of asymptomatic individuals were infectious to mosquitoes. This contrasts with earlier findings and is plausibly due to the low parasite densities in this population.

Keywords: Asymptomatic; Infectiousness; Longitudinal; Membrane feeding assay; P. falciparum, P. vivax; Transmission.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Animals
  • Anopheles* / parasitology
  • Asymptomatic Infections / epidemiology
  • Child
  • Child, Preschool
  • Ethiopia / epidemiology
  • Female
  • Humans
  • Longitudinal Studies
  • Malaria, Falciparum* / epidemiology
  • Malaria, Falciparum* / parasitology
  • Malaria, Falciparum* / transmission
  • Malaria, Vivax* / epidemiology
  • Malaria, Vivax* / parasitology
  • Malaria, Vivax* / transmission
  • Male
  • Middle Aged
  • Mosquito Vectors / parasitology
  • Plasmodium falciparum* / isolation & purification
  • Plasmodium vivax* / isolation & purification
  • Plasmodium vivax* / physiology
  • Young Adult