title: Dynamics of the Human Infectious Reservoir for Malaria Determined by Mosquito Feeding Assays and Ultrasensitive Malaria Diagnosis in Burkina Faso.
abstract: BACKGROUND
  Plasmodium falciparum gametocytes are essential for malaria transmission. Malaria control measures that aim at reducing transmission require an accurate characterization of the human infectious reservoir.
  
  
  METHODS
  We longitudinally determined human infectiousness to mosquitoes and P. falciparum carriage by an ultrasensitive RNA-based diagnostics in 130 randomly selected inhabitants of an endemic area.
  
  
  RESULTS
  At least 1 mosquito was infected by 32.6% (100 of 307) of the blood samples; in total, 7.6% of mosquitoes (916 of 12 079) were infected. The proportion of infectious individuals and infected mosquitoes were negatively associated with age and positively with asexual parasites (P < .001). Human infectiousness was higher at the start of the wet season and subsequently declined at the peak of the wet season (adjusted odds ratio, 0.52; P = .06) and in the dry season (0.23; P < .001). Overall, microscopy-negative individuals were responsible for 28.7% of infectious individuals (25 of 87) and 17.0% of mosquito infections (145 of 855).
  
  
  CONCLUSIONS
  Our study reveals that the infectious reservoir peaks at the start of the wet season, with prominent roles for infections in children and submicroscopic infections. These findings have important consequences for strategies and the timing of interventions, which need to include submicroscopic infections and be implemented in the dry season.
authors.affiliation: Institute for Disease Modeling, Bellevue, Washington Département de Sciences Biomédicales, Centre National de Recherche et de Formation sur le Paludisme.
authors.forename: André Lin
authors.initials: AL
authors.lastname: Ouédraogo
authors.affiliation: Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, United Kingdom.
authors.forename: Bronner P
authors.initials: BP
authors.lastname: Gonçalves
authors.affiliation: Département de Sciences Biomédicales, Centre National de Recherche et de Formation sur le Paludisme Université de Ouagadougou.
authors.forename: Awa
authors.initials: A
authors.lastname: Gnémé
authors.affiliation: Institute for Disease Modeling, Bellevue, Washington.
authors.forename: Edward A
authors.initials: EA
authors.lastname: Wenger
authors.affiliation: Département de Sciences Biomédicales, Centre National de Recherche et de Formation sur le Paludisme.
authors.forename: Moussa W
authors.initials: MW
authors.lastname: Guelbeogo
authors.affiliation: Département de Sciences Biomédicales, Centre National de Recherche et de Formation sur le Paludisme.
authors.forename: Amathe
authors.initials: A
authors.lastname: Ouédraogo
authors.affiliation: Institute for Disease Modeling, Bellevue, Washington.
authors.forename: Jaline
authors.initials: J
authors.lastname: Gerardin
authors.affiliation: Institute for Disease Modeling, Bellevue, Washington.
authors.forename: Caitlin A
authors.initials: CA
authors.lastname: Bever
authors.affiliation: Institute for Disease Modeling, Bellevue, Washington.
authors.forename: Hil
authors.initials: H
authors.lastname: Lyons
authors.affiliation: Département de Sciences Biomédicales, Centre National de Recherche et de Formation sur le Paludisme Africa Indoor Residual Spraying, Abt Associates, Madagascar.
authors.forename: Xavier
authors.initials: X
authors.lastname: Pitroipa
authors.affiliation: Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Jan Peter
authors.initials: JP
authors.lastname: Verhave
authors.affiliation: Institute for Disease Modeling, Bellevue, Washington.
authors.forename: Philip A
authors.initials: PA
authors.lastname: Eckhoff
authors.affiliation: Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, United Kingdom.
authors.forename: Chris
authors.initials: C
authors.lastname: Drakeley
authors.affiliation: Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Robert
authors.initials: R
authors.lastname: Sauerwein
authors.affiliation: Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands Institut de Recherche pour le Développement, Mère et Enfant Face aux Infections Tropicales Faculté de Pharmacie, Sorbonne Paris Cité, Université Paris Descartes, France.
authors.forename: Adrian J F
authors.initials: AJ
authors.lastname: Luty
authors.affiliation: Département de Sciences Biomédicales, Centre National de Recherche et de Formation sur le Paludisme Ministère de la Santé, Ouagadougou, Burkina Faso.
authors.forename: Bocar
authors.initials: B
authors.lastname: Kouyaté
authors.affiliation: Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, United Kingdom Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Teun
authors.initials: T
authors.lastname: Bousema
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D000852:Anopheles / Q000469:parasitology / Q000502:physiology; D002050:Burkina Faso / Q000453:epidemiology; D002353:Carrier State / Q000453:epidemiology / Q000469:parasitology / Q000635:transmission; D002648:Child; D004197:Disease Reservoirs / Q000469:parasitology; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007303:Insect Vectors / Q000469:parasitology / Q000502:physiology; D008137:Longitudinal Studies; D016778:Malaria, Falciparum / Q000453:epidemiology / Q000469:parasitology / Q000635:transmission; D008297:Male; D010963:Plasmodium falciparum; D055815:Young Adult
keywords: Burkina Faso; QT-NASBA; dynamics; falciparum; feeding; gametocyte; malaria; mosquito; reservoir; season