Table 2 Factors associated with intra-host Plasmodium falciparum diversity among first antenatal care users and children

From: Genomic malaria surveillance of antenatal care users detects reduced transmission following elimination interventions in Mozambique

First ANC users

eMOI

  

% polyclonal

  

1-Fws

  

(95% CI)

p

p*

(95% CI)

p

p*

(95% CI)

p

p*

All (n = 289)

1.82 (1.72;1.93)

  

51.2 (45.5;56.9)

  

0.39 (0.30;0.50)

  

Year

0.37

0.023

 

0.82

0.18

 

0.65

0.39

 2017 (n = 166)

1.86 (1.73;2.01)

  

50.6 (42.8;58.4)

  

0.41 (0.29;0.57)

  

 2018–2019 (n = 123)

1.76 (1.50;2.16)

  

52.0 (42.9;61.1)

  

0.36 (0.15;0.85)

  

 Change per year

−0.14 (−0.31;0.03)

0.10

0.0010

NA

NA

0.040

−0.10 (−0.44;0.23)

0.56

0.41

Area

0.015

0.00083

 

0.71

0.21

 

0.36

0.27

 Magude (n = 120)

2.00 (1.83;2.19)

  

53.3 (44.0;62.4)

  

0.48 (0.32;0.70)

  

 Manhiça (n = 64)

1.73 (1.43;2.21)

  

46.9 (34.5;59.7)

  

0.33 (0.11;0.95)

  

 Ilha Josina (n = 105)

1.67 (1.41;2.06)

  

51.4 (41.5;61.2)

  

0.33 (0.12;0.85)

  

Parasite density

1.9e-08

3.0e-09

 

0.0011

0.00041

 

0.11

0.12

 <100 p/µL (n = 103)

1.44 (1.32;1.58)

  

35.9 (26.9;46.0)

  

0.26 (0.16;0.42)

  

 100–<1000 p/µL (n = 106)

1.89 (1.46;2.69)

  

62.3 (52.3;71.3)

  

0.44 (0.14;1.30)

  

 ≥1000 p/µL (n = 80)

2.21 (1.63;3.30)

  

56.2 (44.7;67.2)

  

0.51 (0.19;1.59)

  

HIV

0.15

0.27

 

0.27

0.28

 

0.42

0.46

 Negative (n = 220)

1.78 (1.67;1.90)

  

49.3 (42.6;56.1)

  

0.37 (0.27;0.49)

  

 Positive (n = 69)

1.96 (1.61;2.47)

  

57.4 (44.8;69.1)

  

0.47 (0.19;1.12)

  

Gravidity

0.0062

0.20

 

0.47

0.75

 

0.39

0.71

 Primigravid (n = 117)

2.00 (1.83;2.19)

  

53.8 (44.4;63.0)

  

0.44 (0.30;0.65)

  

 Multigravid (n = 172)

1.70 (1.45; 2.07)

  

49.4 (41.8;57.1)

  

0.35 (0.14;0.88)

  

Season

0.46

0.73

 

0.63

0.38

 

0.98

0.89

 Dry (n = 182)

1.85 (1.72;1.99)

  

50.0 (42.8;57.2)

  

0.39 (0.28;0.53)

  

 Rainy (n = 107)

1.77 (1.50;2.17)

  

53.3 (43.4;62.9)

  

0.39 (0.16;0.90)

  

Children 2–10 years

All (n = 93)

2.30 (2.08;2.54)

  

62.4 (52.2;71,5)

  

0.55 (0.36;0.84)

  

Year

6.0e-06

0.00022

 

0.81

0.94

 

0.41

0.71

 2015–2016 (n = 60)

2.65 (2.35;3.00)

  

63.3 (49.8;75.1)

  

0.68 (0.40;1.12)

  

 2017 (n = 4)

1.96 (1.23;3.81)

  

75.0 (21.9;98.7)

  

0.49 (0.02;6.52)

  

 2018–2019 (n = 29)

1.60 (1.28;2.17)

  

58.6 (39.1;75.9)

  

0.35 (0.02;1.51)

  

Change per year

−0.41 (−0,59;−0.25)

2.0e-07

0.00017

NA

NA

0.95

−0.21 (−0.55;0.12)

0.22

0.77

Area

0.0052

0.0013

 

0.51

0.082

 

0.25

0.58

 Magude (n = 47)

2.40 (2.09;2.76)

  

61.7 (46.4;75.1)

  

0.52 (0.28;0.94)

  

 Manhiça (n = 42)

2.30 (1.71;3.35)

  

69.0 (52.8;81.9)

  

0.66 (0.15;2.85)

  

 I. Josina (n = 4)

1.00 (-Inf;1.53)

  

NA*

  

0.04 (NA;1.74)

  

Parasite density

3.0e-07

8.0e-07

 

0.73

0.48

 

0.53

0.46

 <100 p/µL (n = 33)

1.76 (1.50;2.10)

  

60.6 (42.2;76.7)

  

0.42 (0.19;0.86)

  

 100–< 1000 p/µL (n = 28)

2.43 (1.57;4.43)

  

67.9 (47.6;83.4)

  

0.65 (0.10;3.93)

  

 ≥1000 p/µL (n = 20)

3.29 (1.93;6.45)

  

70.0 (45.7;87.2)

  

0.78 (0.11;5.17)

  
  1. eMOI effective multiplicity of infection, estimated with MOIRE (R package). Means and 95% confidence intervals (CI) obtained from 0-truncated Poisson regression, with p values computed with likelihood ratio tests.
  2. Polyclonal infections are defined as having an eMOI>1.1. 95% CI obtained with Z test of proportions, p values with chi square goodness-of-fit test, and adjusted p values with likelihood ratio test in multivariate logistic regression.
  3. Fws within-host heterozygosity relative to population-level expected heterozygosity at a given allele. Means and 95% CI are obtained from logistic regression, with p values from likelihood ratio tests. p value for univariate analysis, p* for multivariate analysis adjusting for parasitemia (categorical), time (continuous), area, and an interaction between time and area, NA not applicable.
  4. *No polyclonal infections were detected among children in Ilha Josina (0/4).
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