Genotyping of Anopheles mosquito blood meals reveals nonrandom human host selection: implications for human-to-mosquito Plasmodium falciparum transmission

Plasma From Older Children in Malawi Inhibits Plasmodium falciparum Binding in 3-Dimensional Brain Microvessels

A hallmark of cerebral malaria is sequestration of Plasmodium falciparum-infected erythrocytes (IEs) in the brain microcirculation. Antibodies contribute to malaria immunity, but it remains unclear whether functional antibodies targeting parasite-expressed ligand can block cytoadhesion in the brain. Here, we screened the plasma of older children and young adults in Malawi to characterize the antibody response against the P. falciparum-IE surface and used a bioengineered 3-dimensional (3D) human brain microvessel model incorporating variable flow dynamics to measure adhesion-blocking responses. We found a strong correlation between surface antibody reactivity by flow cytometry and reduced P. falciparum-IE binding in 3D microvessels. Moreover, there was a threshold of surface antibody reactivity necessary to achieve robust inhibitory activity. Our findings provide evidence of the acquisition of adhesion-blocking antibodies against cerebral binding variants in people exposed to stable P. falciparum transmission and suggest the quality of the inhibitory response can be influenced by flow dynamics.

Anopheles mosquito exposure is associated with age, gender and bed net use in areas in Uganda experiencing varying malaria transmission intensity

Objectives

The number of Anopheles mosquito bites a person receives determines the risk of acquiring malaria and the likelihood of transmitting infections to mosquitoes. We assessed heterogeneity in Anopheles biting and associated factors in two settings in Uganda with different endemicity.

Methods

Plasmodium falciparum parasites in blood-fed indoor caught Anopheles mosquitoes were quantified using qPCR targeting the Pf18S rRNA gene. Human DNA in dried blood spots from household occupants and mosquito blood meals was profiled using 15 short-tandem repeats (STRs) and analysed using a log-likelihood approach for matching of both single and multi-sourced blood meals and incomplete DNA profiles.

Results

The distribution of mosquito bites was non-random; school-age children (5-15 years) and adults (≥16 years) had a mosquito biting rate ratio (BRR) 1.76 (95%CI 1.27-2.44, P < 0.001) and 1.96 (95%CI 1.41-2.73, P < 0.0001) times that of children under 5 years, respectively. Biting rates were lower in bed net users (BRR: 0.80, 95%CI 0.65-0.99, P = 0.042), and higher in males (BRR: 1.30, 95%CI 1.01-1.66, P = 0.043) and individuals infected with P. falciparum (BRR: 1.42, 95%CI 1.03-1.96, P = 0.030), though the latter effect lost statistical significance in sensitivity analyses.

Conclusions

Adults and school-age children are at higher risk for receiving mosquito bites and this has implications for the relative importance of demographic populations to onward malaria transmission to mosquitoes.

Host Preferences and Impact of Climate on Blood Feeding in Anopheles funestus Group from South Africa

Anopheles vaneedeni and Anopheles parensis (members of the An. funestus group) are generally not considered malaria vectors. However, both species were recently identified as potential vectors in South Africa. A critical factor needed to determine their role in malaria transmission is their preference for human blood. The human blood index of An. vaneedeni and An. parensis and their potential role in the ongoing residual malaria transmission in South Africa is unknown. This study aimed to identify host blood meals from the wild-caught An. funestus group in a longitudinal study, and to establish the relationship between temperature, relative humidity, and precipitation on host feeding preferences. Anopheles leesoni, An. parensis, An. vaneedeni, and Anopheles rivulorum were collected, and females mainly fed on cattle. Climatic parameters did not influence the host feeding preferences of these four members of the An. funestus group, but impacted the proportion of females that took a blood meal. Significant changes in feeding proportions were driven by relative humidity, temperature, and precipitation. The role of these species in the ongoing residual malaria transmission in South Africa needs further investigation, as no human blood meals were identified. It is recommended that vector surveillance teams incorporate climatic monitoring and host blood meal identification into their routine activities. This information could provide the malaria vector control programmes with scientific evidence to evaluate the importance of the An. funestus group in residual malaria transmission.

A Five-Year Malaria Prevalence/Frequency in Makenene in a Forest-Savannah Transition Ecozone of Central Cameroon: The Results of a Retrospective Study

OBJECTIVE

Understanding the epidemiological features of malaria is a key step to monitoring and quantifying the impact of the current control efforts to inform future ones. This study establishes the prevalence and frequency of malaria in a forest-savannah ecozone for 5 consecutive years in Cameroon.

METHODS

A retrospective study was conducted in 3 health centers of Makenene from 2016 to 2020, a period covering the second long-lasting insecticide net mass distribution campaign. Malaria infectious records were reviewed from laboratory registers. The difference in exposure to malaria was estimated using a regression logistic model.

RESULTS

A total of 13525 patients underwent malaria diagnostic tests, with a general malaria prevalence of 65.3%. A greater prevalence of malaria was observed in males (68.39%) compared to females (63.14%). The frequency of consultations in health centers was dominated by females, with a gender ratio (M/F) of 0.66. Annual trends in malaria prevalence slightly varied from 2016 to 2020, exceeding 60%: 65.2% in 2016; 66.7% in 2017, 68.1% in 2018, 63.2% in 2019, and 65.3% in 2020, with a significant seasonal variation (p < 0.0001). The highest malaria prevalence was observed during the short rainy season, no matter the year. Among positive cases, the most represented age groups were 6-15 (p < 0.0001), followed by those under 5, while the age group >25 years was the least represented.

CONCLUSION

Close monitoring and additional intervention measures for malaria control are needed, as are more studies on vector bionomics and transmission patterns.

À la carte: how mosquitoes choose their blood meals

Mosquitoes are important vectors for human diseases, transmitting pathogens that cause a range of parasitic and viral infections. Mosquito blood-feeding is heterogeneous, meaning that some human hosts are at higher risk of receiving bites than others, and this heterogeneity is multifactorial. Mosquitoes integrate specific cues to locate their hosts, and mosquito attraction differs considerably between individual human hosts. Heterogeneous mosquito biting results from variations in both host attractiveness and availability and can impact transmission of vector-borne diseases. However, the extent and drivers of this heterogeneity and its importance for pathogen transmission remain incompletely understood. Here, we review methods and recent data describing human characteristics that affect host-seeking behavior and host preferences of mosquito disease vectors, and the implications for vector-borne disease transmission.

Plasmodium falciparum infection in humans and mosquitoes influence natural Anopheline biting behavior and transmission

The human infectious reservoir of Plasmodium falciparum is governed by transmission efficiency during vector-human contact and mosquito biting preferences. Understanding biting bias in a natural setting can help target interventions to interrupt transmission. In a 15-month cohort in western Kenya, we detected P. falciparum in indoor-resting Anopheles and human blood samples by qPCR and matched mosquito bloodmeals to cohort participants using short-tandem repeat genotyping. Using risk factor analyses and discrete choice models, we assessed mosquito biting behavior with respect to parasite transmission. Biting was highly unequal; 20% of people received 86% of bites. Biting rates were higher on males (biting rate ratio (BRR): 1.68; CI: 1.28-2.19), children 5-15 years (BRR: 1.49; CI: 1.13-1.98), and P. falciparum-infected individuals (BRR: 1.25; CI: 1.01-1.55). In aggregate, P. falciparum-infected school-age (5-15 years) boys accounted for 50% of bites potentially leading to onward transmission and had an entomological inoculation rate 6.4x higher than any other group. Additionally, infectious mosquitoes were nearly 3x more likely than non-infectious mosquitoes to bite P. falciparum-infected individuals (relative risk ratio 2.76, 95% CI 1.65-4.61). Thus, persistent P. falciparum transmission was characterized by disproportionate onward transmission from school-age boys and by the preference of infected mosquitoes to feed upon infected people.

Malaria prevention in children: an update

PURPOSE OF REVIEW

Malaria cases and deaths decreased from 2000 to 2015 but remain increased since 2019. Several new developments and strategies could help reverse this trend. The purpose of this review is to discuss new World Health Organization (WHO) guidelines and recent research on malaria prevention in children.

RECENT FINDINGS

Fifteen countries have now rolled out seasonal malaria chemoprophylaxis (SMC) in children at highest risk for severe malaria, and new WHO recommendations provide more flexibility for SMC implementation in terms of target age groups, geographic region, and number of cycles. Recent studies confirm that malaria burden in school aged children, and their contribution to transmission, is high. New guidelines permit expanded chemoprevention options for these children. Two vaccines have been approved for use in malaria endemic countries, RTS,S/AS01 E and R21/Matrix-M. Additionally, pyrethroid-chlorfenapyr bed nets are being deployed to combat resistant mosquitoes.

SUMMARY

While challenges remain in malaria control towards elimination, new guidelines and recently approved vaccines offer hope. Monitoring for continued vaccine and chemoprevention effectiveness, and for possible epidemiologic shifts in severe malaria presentation and deaths as additional prevention efforts roll out will be paramount.

bistro: An R package for vector bloodmeal identification by short tandem repeat overlap

1. Measuring vector-human contact in a natural setting can inform precise targeting of interventions to interrupt transmission of vector-borne diseases. One approach is to directly match human DNA in vector bloodmeals to the individuals who were bitten using genotype panels of discriminative short tandem repeats (STRs). Existing methods for matching STR profiles in bloodmeals to the people bitten preclude the ability to match most incomplete profiles and multi-source bloodmeals to bitten individuals. 2. We developed bistro, an R package that implements 3 preexisting STR matching methods as well as the package's namesake, bistro, a new algorithm described here. bistro employs forensic analysis methods to calculate likelihood ratios and match human STR profiles in bloodmeals to people using a dynamic threshold. We evaluated the algorithm's accuracy and compared it to existing matching approaches using a publicly-available panel of 188 single-source and 100 multi-source samples containing DNA from 50 known human sources. Then we applied it to match 777 newly field-collected mosquito bloodmeals to a database of 645 people. 3. The R package implements four STR matching algorithms in user-friendly functions with clear documentation. bistro correctly matched 99% (184/185) of profiles in single-source samples, and 63% (225/359) of profiles from multi-source samples, resulting in a sensitivity of 0.75 (vs < 0.51 for other algorithms). The specificity of bistro was 0.9998 (vs. 1 for other algorithms). Furthermore, bistro identified 80% (729/909) of all possible matches for field-derived mosquitoes, yielding 1.4x more matches than existing algorithms. 4. bistro identifies more correct bloodmeal-human matches than existing approaches, enabling more accurate and robust analyses of vector-human contact in natural settings. The bistro R package and corresponding documentation allow for straightforward uptake of this algorithm by others.