10-year longitudinal study of malaria in children: Insights into acquisition and maintenance of naturally acquired immunity.

Autor:	Addy JWG; Malaria Immunology Laboratory, Francis Crick Institute, London, UK., Bediako Y; Malaria Immunology Laboratory, Francis Crick Institute, London, UK.; West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Accra, Ghana., Ndungu FM; KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya., Valetta JJ; School of Mathematics and Statistics, University of St Andrews, St Andrews, UK., Reid AJ; Parasite Genomics, Wellcome Sanger Institute, Hixton, UK., Mwacharo J; KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya., Ngoi JM; KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya., Wambua J; KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya., Otieno E; KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya., Musyoki J; KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya., Said K; KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya., Berriman M; Parasite Genomics, Wellcome Sanger Institute, Hixton, UK., Marsh K; Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK., Bejon P; KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya., Recker M; Centre for Ecology and Conservation, University of Exeter, Penryn Campus, Penryn, UK., Langhorne J; Malaria Immunology Laboratory, Francis Crick Institute, London, UK.
Jazyk:	angličtina
Zdroj:	Wellcome open research [Wellcome Open Res] 2021 Dec 03; Vol. 6, pp. 79. Date of Electronic Publication: 2021 Dec 03 (Print Publication: 2021).
DOI:	10.12688/wellcomeopenres.16562.2
Abstrakt:	Background: Studies of long-term malaria cohorts have provided essential insights into how Plasmodium falciparum interacts with humans, and influences the development of antimalarial immunity. Immunity to malaria is acquired gradually after multiple infections, some of which present with clinical symptoms. However, there is considerable variation in the number of clinical episodes experienced by children of the same age within the same cohort. Understanding this variation in clinical symptoms and how it relates to the development of naturally acquired immunity is crucial in identifying how and when some children stop experiencing further malaria episodes. Where variability in clinical episodes may result from different rates of acquisition of immunity, or from variable exposure to the parasite. Methods: Using data from a longitudinal cohort of children residing in an area of moderate P. falciparum transmission in Kilifi district, Kenya, we fitted cumulative episode curves as monotonic-increasing splines, to 56 children under surveillance for malaria from the age of 5 to 15. Results: There was large variability in the accumulation of numbers of clinical malaria episodes experienced by the children, despite being of similar age and living in the same general location. One group of children from a particular sub-region of the cohort stopped accumulating clinical malaria episodes earlier than other children in the study. Despite lack of further clinical episodes of malaria, these children had higher asymptomatic parasite densities and higher antibody titres to a panel of P. falciparum blood-stage antigens. Conclusions: This suggests development of clinical immunity rather than lack of exposure to the parasite, and supports the view that this immunity to malaria disease is maintained by a greater exposure to P. falciparum , and thus higher parasite burdens. Our study illustrates the complexity of anti-malaria immunity and underscores the need for analyses which can sufficiently reflect the heterogeneity within endemic populations. Competing Interests: No competing interests were disclosed. (Copyright: © 2021 Addy JWG et al.)
Databáze:	MEDLINE
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