Journal
JOURNAL OF INFECTIOUS DISEASES
Volume 214, Issue 7, Pages 1072-1080Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/infdis/jiw301
Keywords
malaria; epidemiology; immunity; heterogeneity in transmission
Categories
Funding
- Centers for Disease Control and Prevention [U62P024421]
- Doris Duke Charitable Foundation
- National Institutes of Health [U19AI089674]
- National Health and Medical Research Council Australia
- National Health and Medical Research Council Australia Infrastructure for Research Institutes Support Scheme
- Victorian State Government Operational Infrastructure Support
Ask authors/readers for more resources
Background. Plasmodium falciparum malaria remains a leading cause of childhood morbidity and mortality. There are important gaps in our understanding of the factors driving the development of antimalaria immunity as a function of age and exposure. Methods. We used data from a cohort of 93 children participating in a clinical trial in Tororo, Uganda, an area of very high exposure to P. falciparum. We jointly quantified individual heterogeneity in the risk of infection and the development of immunity against infection and clinical disease. Results. Results showed significant heterogeneity in the hazard of infection and independent effects of age and cumulative number of infections on the risk of infection and disease. The risk of developing clinical malaria upon infection decreased on average by 6% (95% confidence interval [CI], 0%-12%) for each additional year of age and by 2% (95% CI, 1%-3%) for each additional prior infection. Children randomly assigned to receive dihydroartemisinin-piperaquine for treatment appeared to develop immunity more slowly than those receiving artemether-lumefantrine. Conclusions. Heterogeneity in P. falciparum exposure and immunity can be independently evaluated using detailed longitudinal studies. Improved understanding of the factors driving immunity will provide key information to anticipate the impact of malaria-control interventions and to understand the mechanisms of clinical immunity.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available