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Sex-based differences in clearance of chronic Plasmodium falciparum infection. eLife Briggs, J., Teyssier, N., Nankabirwa, J. I., Rek, J., Jagannathan, P., Arinaitwe, E., Bousema, T., Drakeley, C., Murray, M., Crawford, E., Hathaway, N., Staedke, S. G., Smith, D., Rosenthal, P. J., Kamya, M., Dorsey, G., Rodriguez-Barraquer, I., Greenhouse, B. 2020; 9

Abstract

Multiple studies have reported a male bias in incidence and/or prevalence of malaria infection in males compared to females. To test the hypothesis that sex-based differences in host-parasite interactions affect the epidemiology of malaria, we intensively followed Plasmodium falciparum infections in a cohort in a malaria endemic area of eastern Uganda and estimated both force of infection (FOI) and rate of clearance using amplicon deep-sequencing. We found no evidence of differences in behavioral risk factors, incidence of malaria, or FOI by sex. In contrast, females cleared asymptomatic infections at a faster rate than males (hazard ratio [HR]=1.82, 95% CI 1.20 to 2.75 by clone and HR = 2.07, 95% CI 1.24 to 3.47 by infection event) in multivariate models adjusted for age, timing of infection onset, and parasite density. These findings implicate biological sex-based differences as an important factor in the host response to this globally important pathogen.

View details for DOI 10.7554/eLife.59872

View details for PubMedID 33107430