J Infect Dis. 2022 Jul 18:jiac294. doi: 10.1093/infdis/jiac294. Online ahead of print.
ABSTRACT
BACKGROUND: The frequency and clinical presentation of malaria infections show marked heterogeneity in epidemiological studies. However, deeper understanding of this variability is hampered by the difficulty in quantifying all relevant factors. Here, we report the history of malaria infections in twins, who are exposed to the same in utero milieu, share genetic factors and are similarly exposed to vectors.
METHODS: Data were obtained from a Malian longitudinal birth cohort. Samples from 25 twin pairs were examined for malaria infection and antibody responses. Bayesian models were developed on the number of infections during follow-up.
RESULTS: In 16/25 pairs, both children were infected and often developed symptoms. In 8/25 pairs, only one twin was infected, but usually only once or twice. Statistical models suggest this pattern is not inconsistent with twin siblings having the same underlying infection rate. In a pair with discordant hemoglobin genotype, parasite densities were consistently lower in the child with hemoglobin AS, but antibody levels were similar.
CONCLUSIONS: By using a novel design, we describe residual variation in malaria phenotypes in naturally-matched children and confirm the important role of environmental factors, as suggested by the between twin pair heterogeneity in malaria history.
PMID:35849702 | DOI:10.1093/infdis/jiac294
