An antigenic diversification threshold for falciparum malaria transmission at high endemicity.

ABSTRACT: In malaria and several other important infectious diseases, high prevalence occurs concomitantly with incomplete immunity. This apparent paradox poses major challenges to malaria elimination in highly endemic regions, where asymptomatic Plasmodium falciparum infections are present across all age classes creating a large reservoir that maintains transmission. This reservoir is in turn enabled by extreme antigenic diversity of the parasite and turnover of new variants. We present here the concept of a threshold in local pathogen diversification that defines a sharp transition in transmission intensity below which new antigen-encoding genes generated by either recombination or migration cannot establish. Transmission still occurs below this threshold, but diversity of these genes can neither

SUBMITTER: He Q 

PROVIDER: S-EPMC7928509 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature