Abstract
BackgroundIndividuals living in areas of high malaria transmission often have different Plasmodium falciparum clones detected in the peripheral blood over time. The aim of this study was to assess the dynamics of asymptomatic P. falciparum infections in a few hours intervals.MethodsCapillary blood samples were collected 6-hourly during five days from asymptomatic children in a highly endemic area in Tanzania. Parasite densities and maturation stages were investigated by light microscopy. Types and number of clones were analysed by PCR based genotyping of the polymorphic merozoite surface proteins 1 and 2 genes. Results: Parasite densities and maturation stages fluctuated 48-hourly with a gradual shift into more mature forms. Various genotyping patterns were observed in repeated samples over five days with only few samples with identical profiles. Up to six alleles differed in samples collected six hours apart in the same individual.ConclusionThis detailed assessment highlights the extensive within-host dynamics of P. falciparum populations and the limitations of single blood samples to determine parasite densities, stages and genotyping profiles in a malaria infected individual.
Highlights
Individuals living in areas of high malaria transmission often have different Plasmodium falciparum clones detected in the peripheral blood over time
Longitudinal studies with repeated genotyping of Plasmodium falciparum infections in partially immune individuals in areas of high malaria transmission have revealed that different parasites are often detected in their peripheral blood over time [1,2,3,4]
Within-host dynamics result in that all parasite types infecting an individual may not be present in the peripheral blood at the time of blood sampling [2,3,4]
Summary
Individuals living in areas of high malaria transmission often have different Plasmodium falciparum clones detected in the peripheral blood over time. Longitudinal studies with repeated genotyping of Plasmodium falciparum infections in partially immune individuals in areas of high malaria transmission have revealed that different parasites are often detected in their peripheral blood over time (days-months) [1,2,3,4]. These changes are a result of new inoculations, immune clearance and intake of anti-malarial drugs. In anti-malarial drug trials, genotyping is used to determine whether recurrent parasitaemias are due to new infections or to recrudescence of the initial parasites suggesting treatment failure [5,6]
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