Immune trajectories enable detection of asymptomatic parasitemia and predict future malaria outcomes

A conserved CD16 monocyte-associated gene module distinguishes asymptomatic parasitemia from uninfected states in Plasmodium infection, independent of parasite density, across 18 countries.

• Why it matters: Asymptomatic carriage is linked to naturally acquired immunity, but the immune program that allows parasites without fever is unclear and limits early detection and outcome prediction.
• What they did: The study integrated 30 transcriptomic datasets (2,578 samples) across 18 countries, validated in three single-cell datasets and 927 new samples, and inferred immune trajectories tied to symptom status.
• The result: The asymptomatic-associated module rose during parasite carriage, fell after clearance, and was associated with protection from future malaria burden in children, while symptomatic malaria tracked lymphopenia and activated CD14 modules with parasite burden.

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