title: Stool microbiota composition is associated with the prospective risk of Plasmodium falciparum infection.
abstract: BACKGROUND
  In humans it is unknown if the composition of the gut microbiota alters the risk of Plasmodium falciparum infection or the risk of developing febrile malaria once P. falciparum infection is established. Here we collected stool samples from a cohort composed of 195 Malian children and adults just prior to an intense P. falciparum transmission season. We assayed these samples using massively parallel sequencing of the 16S ribosomal RNA gene to identify the composition of the gut bacterial communities in these individuals. During the ensuing 6-month P. falciparum transmission season we examined the relationship between the stool microbiota composition of individuals in this cohort and their prospective risk of both P. falciparum infection and febrile malaria.
  
  
  RESULTS
  Consistent with prior studies, stool microbial diversity in the present cohort increased with age, although the overall microbiota profile was distinct from cohorts in other regions of Africa, Asia and North America. Age-adjusted Cox regression analysis revealed a significant association between microbiota composition and the prospective risk of P. falciparum infection; however, no relationship was observed between microbiota composition and the risk of developing febrile malaria once P. falciparum infection was established.
  
  
  CONCLUSIONS
  These findings underscore the diversity of gut microbiota across geographic regions, and suggest that strategic modulation of gut microbiota composition could decrease the risk of P. falciparum infection in malaria-endemic areas, potentially as an adjunct to partially effective malaria vaccines.
authors: J. Craig Venter Institute, 4120 Capricorn Lane, La Jolla, CA, 92037, USA. syooseph@jcvi.org.
authors: Shibu
authors: S
authors: Yooseph
authors: J. Craig Venter Institute, 9704 Medical Center Drive, Rockville, MD, 20850, USA. ekirknes@jcvi.org.
authors: Ewen F
authors: EF
authors: Kirkness
authors: Laboratory of Immunogenetics, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, 20852, USA. tuan.tran@nih.gov.
authors: Tuan M
authors: TM
authors: Tran
authors: J. Craig Venter Institute, 9704 Medical Center Drive, Rockville, MD, 20850, USA. dharkins@jcvi.org.
authors: Derek M
authors: DM
authors: Harkins
authors: J. Craig Venter Institute, 4120 Capricorn Lane, La Jolla, CA, 92037, USA. mjones@jcvi.org.
authors: Marcus B
authors: MB
authors: Jones
authors: J. Craig Venter Institute, 9704 Medical Center Drive, Rockville, MD, 20850, USA. MTorralba@jcvi.org.
authors: Manolito G
authors: MG
authors: Torralba
authors: Laboratory of Parasitic Diseases, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, 20892, USA. elise.o'connell@nih.gov.
authors: Elise
authors: E
authors: O'Connell
authors: Laboratory of Parasitic Diseases, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, 20892, USA. TNUTMAN@niaid.nih.gov.
authors: Thomas B
authors: TB
authors: Nutman
authors: Malaria Research and Training Centre, Department of Epidemiology of Parasitic Diseases, International Center of Excellence in Research, University of Sciences, Technique and Technology of Bamako, Bamako, Mali. Sdoumbo@icermali.org.
authors: Safiatou
authors: S
authors: Doumbo
authors: Malaria Research and Training Centre, Department of Epidemiology of Parasitic Diseases, International Center of Excellence in Research, University of Sciences, Technique and Technology of Bamako, Bamako, Mali. okd@icermali.org.
authors: Ogobara K
authors: OK
authors: Doumbo
authors: Malaria Research and Training Centre, Department of Epidemiology of Parasitic Diseases, International Center of Excellence in Research, University of Sciences, Technique and Technology of Bamako, Bamako, Mali. Bouba.traore@icermali.org.
authors: Boubacar
authors: B
authors: Traore
authors: Laboratory of Immunogenetics, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, 20852, USA. pcrompton@niaid.nih.gov.
authors: Peter D
authors: PD
authors: Crompton
authors: J. Craig Venter Institute, 4120 Capricorn Lane, La Jolla, CA, 92037, USA. kenelson@jcvi.org.
authors: Karen E
authors: KE
authors: Nelson
mesh_terms: D000293:Adolescent; D001419:Bacteria / Q000145:classification* / Q000302:isolation & purification; D002648:Child; D002675:Child, Preschool; D005243:Feces / Q000382:microbiology*; D005260:Female; D059014:High-Throughput Nucleotide Sequencing / Q000379:methods*; D006801:Humans; D007223:Infant; D016778:Malaria, Falciparum / Q000097:blood / Q000469:parasitology* / Q000635:transmission; D008297:Male; D008302:Mali / Q000453:epidemiology; D064307:Microbiota; D011446:Prospective Studies; D012329:RNA, Bacterial / Q000032:analysis; D012336:RNA, Ribosomal, 16S / Q000032:analysis; D012307:Risk Factors; D017423:Sequence Analysis, RNA / Q000379:methods*; D055815:Young Adult
chemical_list: D012329:RNA, Bacterial; D012336:RNA, Ribosomal, 16S