Gradual acquisition of immunity to severe malaria with increasing exposure

Griffin, J. T., Hollingsworth, Deirdre, Reyburn, H., Drakeley, C. J., Riley, E. M. and Ghani, A. C. (2015) 'Gradual acquisition of immunity to severe malaria with increasing exposure'. Proceedings of the Royal Society B: Biological Sciences, Vol 282, Issue 1801, p. 20142657.

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Abstract

Previous analyses have suggested that immunity to non-cerebral severe malaria due to Plasmodium falciparum is acquired after only a few infections, whereas longitudinal studies show that some children experience multiple episodes of severe disease, suggesting that immunity may not be acquired so quickly. We fitted a mathematical model for the acquisition and loss of immunity to severe disease to the age distribution of severe malaria cases stratified by symptoms from a range of transmission settings in Tanzania, combined with data from several African countries on the age distribution and overall incidence of severe malaria. We found that immunity to severe disease was acquired more gradually with exposure than previously thought. The model also suggests that physiological changes, rather than exposure, may alter the symptoms of disease with increasing age, suggesting that a later age at infection would be associated with a higher proportion of cases presenting with cerebral malaria regardless of exposure. This has consequences for the expected pattern of severe disease as transmission changes. Careful monitoring of the decline in immunity associated with reduced transmission will therefore be needed to ensure rebound epidemics of severe and fatal malaria are avoided.

Item Type:	Article
Subjects:	QW Microbiology and Immunology > Immunity by Type > QW 551 Acquired immunity. Artificial immunity QX Parasitology > Protozoa > QX 135 Plasmodia WA Public Health > Preventive Medicine > WA 110 Prevention and control of communicable diseases. Transmission of infectious diseases WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.1098/rspb.2014.2657
Depositing User:	Lynn Roberts-Maloney
Date Deposited:	09 Jul 2015 08:37
Last Modified:	06 Feb 2018 13:10
URI:	https://archive.lstmed.ac.uk/id/eprint/5237

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