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

• Published in: Malaria Journal
• Main Authors: Helena Lamptey, Michael Fokuo Ofori, Kwadwo Asamoah Kusi, Bright Adu, Eunice Owusu-Yeboa, Eric Kyei-Baafour, Andrea Twumwaa Arku, Samuel Bosomprah, Michael Alifrangis, Isabella A. Quakyi
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2018
• Subjects: Plasmodium falciparum; Gametocyte prevalence; Submicroscopic infections; Multiplicity of infection; Seroprevalence; Pfs230; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1186/s12936-018-2479-y; https://doaj.org/article/d123e25ee46943ddade1613e94912c98

Abstract 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 Pfs230 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 Pfs25-real time PCR. Multiclonal P. falciparum infections were estimated by msp2 genotyping and an indirect ELISA was used to measure plasma IgG antibodies to Pfs230 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 Pfmsp2 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-Pfs230 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 ...