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Sex-based differences in clearance of chronic Plasmodium falciparum infection.

Jessica J BriggsNoam TeyssierJoaniter I NankabirwaJohn RekPrasanna JagannathanEmmanuel ArinaitweTeun BousemaChris J DrakeleyMargaret MurrayEmily CrawfordNicholas HathawaySarah G StaedkeDavid SmithPhillip J RosenthalMoses KamyaGrant DorseyIsabel Rodriguez-BarraquerBryan Greenhouse
Published in: eLife (2020)
Multiple studies have reported a male bias in incidence and/or prevalence of malaria infection in males compared to females. To test the hypothesis that sex-based differences in host-parasite interactions affect the epidemiology of malaria, we intensively followed Plasmodium falciparum infections in a cohort in a malaria endemic area of eastern Uganda and estimated both force of infection (FOI) and rate of clearance using amplicon deep-sequencing. We found no evidence of differences in behavioral risk factors, incidence of malaria, or FOI by sex. In contrast, females cleared asymptomatic infections at a faster rate than males (hazard ratio [HR]=1.82, 95% CI 1.20 to 2.75 by clone and HR = 2.07, 95% CI 1.24 to 3.47 by infection event) in multivariate models adjusted for age, timing of infection onset, and parasite density. These findings implicate biological sex-based differences as an important factor in the host response to this globally important pathogen.
Keyphrases
  • plasmodium falciparum
  • risk factors
  • magnetic resonance imaging
  • single cell
  • single molecule
  • data analysis