title: Immunological consequences of intermittent preventive treatment against malaria in Senegalese preschool children.
abstract: BACKGROUND
  Intermittent preventive treatment in children (IPTc) is a promising strategy to control malaria morbidity. A significant concern is whether IPTc increases children's susceptibility to subsequent malaria infection by altering their anti-Plasmodium acquired immunity.
  
  
  METHODS
  To investigate this concern, IgG antibody (Ab) responses to Plasmodium falciparum schizont extract were measured in Senegalese children (6 months-5 years old) who had received three rounds of IPTc with artesunate + sulphadoxine-pyrimethamine (or placebo) at monthly intervals eight months earlier. Potential confounding factors, such as asexual malaria parasitaemia and nutritional status were also evaluated.
  
  
  RESULTS
  Firstly, a bivariate analysis showed that children who had received IPTc had lower anti-Plasmodium IgG Ab levels than the non-treated controls. When epidemiological parameters were incorporated into a multivariate regression, gender, nutritional status and haemoglobin concentration did not have any significant influence. In contrast, parasitaemia, past malaria morbidity and increasing age were strongly associated with a higher specific IgG response.
  
  
  CONCLUSIONS
  The intensity of the contacts with P. falciparum seems to represent the main factor influencing anti-schizont IgG responses. Previous IPTc does not seem to interfere with this parasite-dependent acquired humoral response eight months after the last drug administration.
authors.affiliation: Unité Mixte de Recherche 145, Institut de Recherche pour le Développement and Université Montpellier 1, 911 avenue Agropolis, BP64501, 34394 Montpellier, France. denis.boulanger@ird.fr
authors.forename: Denis
authors.initials: D
authors.lastname: Boulanger
authors.forename: Jean Biram
authors.initials: JB
authors.lastname: Sarr
authors.forename: Florie
authors.initials: F
authors.lastname: Fillol
authors.forename: Cheikh
authors.initials: C
authors.lastname: Sokhna
authors.forename: Badara
authors.initials: B
authors.lastname: Cisse
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Schacht
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Trape
authors.forename: Gilles
authors.initials: G
authors.lastname: Riveau
authors.forename: François
authors.initials: F
authors.lastname: Simondon
authors.forename: Brian
authors.initials: B
authors.lastname: Greenwood
authors.forename: Franck
authors.initials: F
authors.lastname: Remoué
mesh_terms: D000913:Antibodies, Protozoan / Q000097:blood*; D000962:Antimalarials / Q000008:administration & dosage*; D037621:Artemisinins / Q000008:administration & dosage; D000077332:Artesunate; D018890:Chemoprevention / Q000379:methods*; D002675:Child, Preschool; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007223:Infant; D008288:Malaria / Q000276:immunology* / Q000517:prevention & control*; D008297:Male; D010919:Placebos / Q000008:administration & dosage; D010963:Plasmodium falciparum / Q000276:immunology*; D011739:Pyrimethamine / Q000008:administration & dosage; D012675:Senegal; D013413:Sulfadoxine / Q000008:administration & dosage
chemical_list: D000913:Antibodies, Protozoan; D000962:Antimalarials; D037621:Artemisinins; D004338:Drug Combinations; D007074:Immunoglobulin G; D010919:Placebos; C001205:fanasil, pyrimethamine drug combination; D000077332:Artesunate; D013413:Sulfadoxine; D011739:Pyrimethamine