title: Modeling malaria infection and immunity against variant surface antigens in Príncipe Island, West Africa.
abstract: After remarkable success of vector control campaigns worldwide, concerns about loss of immunity against Plasmodium falciparum due to lack of exposure to the parasite are relevant since an increase of severe cases in less immune individuals is expected. We present a mathematical model to investigate the impact of reducing exposure to the parasite on the immune repertoire against P. falciparum erythrocyte membrane protein 1 (PfEMP1) variants. The model was parameterized with data from Príncipe Island, West Africa, and applied to simulate two alternative transmission scenarios: one where control measures are continued to eventually drive the system to elimination; and another where the effort is interrupted after 6 years of its initiation and the system returns to the initial transmission potential. Population dynamics of parasite prevalence predict that in a few years infection levels return to the pre-control values, while the re-acquisition of the immune repertoire against PfEMP1 is slower, creating a window for increased severity. The model illustrates the consequences of loss of immune repertoire against PfEMP1 in a given setting and can be applied to other regions where similar data may be available.
authors: Instituto Gulbenkian de Ciência, Oeiras, Portugal.
authors: Cátia
authors: C
authors: Bandeiras
authors: Instituto Gulbenkian de Ciência, Oeiras, Portugal.
authors: Maria Jesus
authors: MJ
authors: Trovoada
authors: Instituto Gulbenkian de Ciência, Oeiras, Portugal.
authors: Lígia A
authors: LA
authors: Gonçalves
authors: Instituto Gulbenkian de Ciência, Oeiras, Portugal.
authors: Cláudio R F
authors: CR
authors: Marinho
authors: Centre for Medical Parasitology, University of Copenhagen and Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark.
authors: Louise
authors: L
authors: Turner
authors: Centre for Medical Parasitology, University of Copenhagen and Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark.
authors: Lars
authors: L
authors: Hviid
authors: Instituto Gulbenkian de Ciência, Oeiras, Portugal.
authors: Carlos
authors: C
authors: Penha-Gonçalves
authors: Instituto Gulbenkian de Ciência, Oeiras, Portugal.
authors: M Gabriela M
authors: MG
authors: Gomes
mesh_terms: D000354:Africa, Western / Q000453:epidemiology; D000913:Antibodies, Protozoan / Q000276:immunology; D000953:Antigens, Protozoan / Q000276:immunology; D003198:Computer Simulation; D014644:Genetic Variation; D006801:Humans; D007109:Immunity; D062312:Islands / Q000453:epidemiology; D016778:Malaria, Falciparum / Q000453:epidemiology / Q000276:immunology* / Q000635:transmission; D018448:Models, Immunological; D010963:Plasmodium falciparum / Q000276:immunology; D015995:Prevalence; D015800:Protozoan Proteins / Q000276:immunology*
chemical_list: D000913:Antibodies, Protozoan; D000953:Antigens, Protozoan; D015800:Protozoan Proteins; C085731:erythrocyte membrane protein 1, Plasmodium falciparum