Close kinship within multiple-genotype malaria parasite infections

Standwell C. Nkhoma, Shalini Nair, Ian H. Cheeseman, Cherise Rohr-Allegrini, Sittaporn Singlam, François Nosten, Tim J C Anderson

Research output: Contribution to journalArticle

56 Scopus citations


Malaria infections containing multiple parasite genotypes are ubiquitous in nature, and play a central role in models of recombination, intra-host dynamics, virulence, sex ratio, immunity and drug resistance evolution in Plasmodium. While these multiple infections (MIs) are often assumed to result from superinfection (bites from multiple infected mosquitoes), we know remarkably little about their composition or generation. We isolated 336 parasite clones from eight patients from Malawi (high transmission) and six from Thailand (low transmission) by dilution cloning. These were genotyped using 384 single-nucleotide polymorphisms, revealing 22 independent haplotypes in Malawi (2–6 per MI) and 15 in Thailand (2–5 per MI). Surprisingly, all six patients from Thailand and six of eight from Malawi contained related haplotypes, and haplotypes were more similar within- than between-infections. These results argue against a simple superinfection model. Instead, the observed kinship patterns may be explained by inoculation of multiple related haploid sporozoites from single mosquito bites, by immune suppression of parasite subpopulations within infections, and serial transmission of related parasites between people. That relatedness is maintained in endemic areas in the face of repeated bites from infected mosquitoes has profound implications for understanding malaria transmission, immunity and intra-host dynamics of co-infecting parasite genotypes.

Original languageEnglish (US)
Pages (from-to)2589-2598
Number of pages10
JournalProceedings. Biological sciences / The Royal Society
Issue number1738
Publication statusPublished - Jul 7 2012
Externally publishedYes



  • Dilution cloning
  • Inbreeding
  • Multiple-clone infection
  • Plasmodium falciparum
  • Relatedness

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Environmental Science(all)
  • Immunology and Microbiology(all)
  • Medicine(all)

Cite this

Nkhoma, S. C., Nair, S., Cheeseman, I. H., Rohr-Allegrini, C., Singlam, S., Nosten, F., & Anderson, T. J. C. (2012). Close kinship within multiple-genotype malaria parasite infections. Proceedings. Biological sciences / The Royal Society, 279(1738), 2589-2598.