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

Authors :: Briggs J
Teyssier N
Nankabirwa JI
Rek J
Jagannathan P
Arinaitwe E
Bousema T
Drakeley C
Murray M
Crawford E
Hathaway N
Staedke SG
Smith D
Rosenthal PJ
Kamya M
Dorsey G
Rodriguez-Barraquer I
Greenhouse B
Source :: ELife [Elife] 2020 Oct 27; Vol. 9. Date of Electronic Publication: 2020 Oct 27.
Publication Year :: 2020
Abstract: 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.<br />Competing Interests: JB, NT, JN, JR, PJ, EA, TB, CD, MM, EC, NH, SS, DS, PR, MK, GD, BG No competing interests declared, IR Reviewing editor, eLife<br /> (© 2020, Briggs et al.)