TY - JOUR
T1 - Sex-based differences in clearance of chronic plasmodium falciparum infection
AU - Briggs, Jessica
AU - Teyssier, Noam
AU - Nankabirwa, Joaniter I.
AU - Rek, John
AU - Jagannathan, Prasanna
AU - Arinaitwe, Emmanuel
AU - Bousema, Teun
AU - Drakeley, Chris
AU - Murray, Margaret
AU - Crawford, Emily
AU - Hathaway, Nicholas
AU - Staedke, Sarah
AU - Smith, David
AU - Rosenthal, Phillip J.
AU - Kamya, Moses
AU - Dorsey, Grant
AU - Rodriguez-Barraquer, Isabel
AU - Greenhouse, Bryan
PY - 2020/10/1
Y1 - 2020/10/1
N2 - 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.
AB - 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.
U2 - 10.7554/elife.59872
DO - 10.7554/elife.59872
M3 - Article
SN - 2050-084X
VL - 9
SP - 1
EP - 14
JO - eLife
JF - eLife
M1 - e59872
ER -
