Immunity to non-cerebral severe malaria is acquired after one or two infections

Citation
S. Gupta et al., Immunity to non-cerebral severe malaria is acquired after one or two infections, NAT MED, 5(3), 1999, pp. 340-343
Citations number
14
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Research/Laboratory Medicine & Medical Tecnology","Medical Research General Topics
Journal title
NATURE MEDICINE
ISSN journal
1078-8956 → ACNP
Volume
5
Issue
3
Year of publication
1999
Pages
340 - 343
Database
ISI
SICI code
1078-8956(199903)5:3<340:ITNSMI>2.0.ZU;2-M
Abstract
In areas of stable transmission, clinical immunity to mild malaria is acqui red slowly, so it is not usually effective until early adolescence. Life-th reatening disease is, however, restricted to a much younger age group, indi cating that resistance to the severe clinical consequences of infection is acquired more quickly. Understanding how rapidly immunity develops to sever e malaria is essential, as severe malaria should be the primary target of i ntervention strategies, and predicting the result of interventions that red uce host exposure will require consideration of these dynamics(1,2). Severe disease in childhood is less frequent in areas where transmission is the g reatest(3). One explanation for this is that infants experience increased e xposure to infection(4-6) while they are protected from disease, possibly b y maternal antibody. They therefore emerge from this period of clinical pro tection with considerably more immunity than those who experience lower tra nsmission intensities. Here we use this data(3), assuming a period of clini cal protection, to estimate the number of prior infections needed to reduce the risk of severe disease to negligible levels. Contrary to expectations, one or two successful infective bites seem to be all that is necessary acr oss a broad range of transmission intensities.