title: Analysis of circulating populations of Plasmodium falciparum in mild and severe malaria in two different epidemiological patterns in Madagascar.
abstract: OBJECTIVE
  To investigate whether the severity of Plasmodium falciparum attack in endemic areas was associated with the multiplicity of infection (MOI) and/or with a particular genotype(s).
  
  
  METHODS
  In two areas of different malaria transmission pattern in Madagascar (Sainte-Marie - mesoendemic and Tsiroanomandidy - hypoendemic) the number and the proportions of msp-2 genotypes within isolates were determined for each patient using a capillary electrophoresis genotyping method. DNA sequencing was performed to identify the msp-2 allelic family of dominant clones.
  
  
  RESULTS
  Eighty six uncomplicated and 33 severe cases were included in Sainte-Marie and 48 uncomplicated and 69 severe cases were included in Tsiroanomandidy. We found no association between the MOI and severity of malaria as the same mean number of msp-2 genotypes was found in isolates from uncomplicated and from severe malaria cases (3.72 and 3.73, respectively, P>0.05). The study of the association of dominant clones with clinical status showed no particular genotype or allelic family associated with malaria severity.
  
  
  CONCLUSIONS
  Severity of malaria was not associated with higher MOI in our study. Severity did not appear restricted to some particular genotypes either. On the contrary, severe malaria appeared to be caused by very common genotypes in the studied areas. More comprehensive explorations including immunity and genetic factors of the host are needed to acquire new information about this complex condition.
authors.affiliation: Laboratoire de Parasitologie Mycologie, AP-HP Hôpital Avicenne, Paris, Cedex, France. remy.durand@avc.aphp.fr
authors.forename: Rémy
authors.initials: R
authors.lastname: Durand
authors.forename: Frédéric
authors.initials: F
authors.lastname: Ariey
authors.forename: Sandrine
authors.initials: S
authors.lastname: Cojean
authors.forename: Arnaud
authors.initials: A
authors.lastname: Fontanet
authors.forename: Louise
authors.initials: L
authors.lastname: Ranaivo
authors.forename: Lanto-Alisoa
authors.initials: LA
authors.lastname: Ranarivelo
authors.forename: Jeanne Aimée
authors.initials: JA
authors.lastname: Vonimpaisomihanta
authors.forename: Didier
authors.initials: D
authors.lastname: Menard
authors.forename: Virginio
authors.initials: V
authors.lastname: Pietra
authors.forename: Jacques
authors.initials: J
authors.lastname: Le Bras
authors.forename: David
authors.initials: D
authors.lastname: Modiano
authors.forename: Milijaona
authors.initials: M
authors.lastname: Randrianarivelojosia
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000483:Alleles; D000818:Animals; D000953:Antigens, Protozoan / Q000235:genetics* / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D004912:Erythrocytes / Q000276:immunology; D005260:Female; D017125:Genes, Protozoan / Q000235:genetics; D005838:Genotype; D006801:Humans; D007223:Infant; D008270:Madagascar / Q000453:epidemiology; D016778:Malaria, Falciparum / Q000453:epidemiology / Q000469:parasitology*; D008297:Male; D008875:Middle Aged; D010963:Plasmodium falciparum / Q000235:genetics* / Q000276:immunology / Q000302:isolation & purification; D011110:Polymorphism, Genetic / Q000235:genetics* / Q000276:immunology; D012423:Rural Health; D012621:Seasons; D017422:Sequence Analysis, DNA / Q000379:methods*; D055815:Young Adult
chemical_list: D000953:Antigens, Protozoan