Data from: The complex relationship of exposure to new Plasmodium infections and incidence of clinical malaria in Papua New Guinea

The molecular force of blood-stage infection (molFOB) is a quantitative
surrogate metric for malaria transmission at population level and for
exposure at individual level. Relationships between molFOB, parasite
prevalence and clinical incidence were assessed in a
treatment-to-reinfection cohort, where P.vivax (Pv) hypnozoites were
eliminated in half the children by primaquine (PQ). Discounting relapses,
children acquired equal numbers of new P. falciparum (Pf) and Pv
blood-stage infections/year (Pf-molFOB=0-18, Pv-molFOB=0-23) resulting in
comparable spatial and temporal patterns in incidence and prevalence of
infections. Including relapses, Pv-molFOB increased >3-fold
(relative to PQ-treated children) showing greater heterogeneity at
individual (Pv-molFOB=0-36) and village levels. Pf- and Pv-molFOB were
strongly associated with clinical episode risk. Yearly Pf clinical
incidence rate (IR=0.28) was higher than for Pv (IR=0.12) despite lower
Pf-molFOB. These relationships between molFOB, clinical incidence and
parasite prevalence reveal a comparable decline in Pf and Pv transmission
that is normally hidden by the high burden of Pv relapses.

血液期感染分子作用力（molecular force of blood-stage infection，简称molFOB）是人群水平疟疾传播以及个体水平疟原虫暴露的定量替代指标。本研究在一项治疗至再感染队列中评估了molFOB、寄生虫患病率与临床发病率之间的关联，该队列中半数儿童接受伯氨喹（primaquine, PQ）治疗以清除间日疟原虫（P.vivax, Pv）休眠子（hypnozoites）。若不考虑复发事件，儿童每年新获得的恶性疟原虫（P. falciparum, Pf）红内期感染与间日疟原虫红内期感染数量相当（Pf-molFOB=0~18，Pv-molFOB=0~23），二者的感染发病率与患病率呈现相似的时空分布特征。若纳入复发事件，相较于接受伯氨喹治疗的儿童，未治疗组的Pv-molFOB升高超过3倍，在个体水平（Pv-molFOB=0~36）与村落水平均表现出更显著的异质性。Pf-molFOB与Pv-molFOB均与临床发作风险显著相关。尽管Pf-molFOB水平更低，但年度Pf临床发病率（IR=0.28）仍高于Pv的临床发病率（IR=0.12）。上述molFOB、临床发病率与寄生虫患病率之间的关联揭示，恶性疟与间日疟的传播下降趋势具有相似性，而这一趋势通常会被间日疟高复发的疾病负担所掩盖。