How is childhood development of immunity to Plasmodium falciparum enhanced by certain antimalarial interventions?
The development of acquired protective immunity to Plasmodium falciparum infection in young African children is considered in the context of three current strategies for malaria prevention: insecticide-impregnated bed nets or curtains, anti-sporozoite vaccines and intermittent preventive therapy. Evidence is presented that each of these measures may permit attenuated P. falciparum blood-stage infections, which do not cause clinical malaria but can act as an effective blood-stage "vaccine". It is proposed that the extended serum half-life, and rarely considered liver-stage prophylaxis provided by the anti-folate combination sulphadoxine-pyrimethamine frequently lead to such attenuated infections in high transmission areas, and thus contribute to the sustained protection from malaria observed among children receiving the combination as intermittent preventative therapy or for parasite clearance in vaccine trials.
Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK. colin.sutherland@lshtm.ac.uk
Colin J
CJ
Sutherland
Christopher J
CJ
Drakeley
David
D
Schellenberg
D000818:Animals; D000962:Antimalarials / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D017780:Malaria Vaccines / Q000627:therapeutic use; D016778:Malaria, Falciparum / Q000276:immunology* / Q000469:parasitology / Q000517:prevention & control; D010963:Plasmodium falciparum / Q000276:immunology* / Q000502:physiology
D000962:Antimalarials; D017780:Malaria Vaccines