A model of parity-dependent immunity to placental malaria


Walker, PGT; Griffin, JT; Cairns, M; Rogerson, SJ; van Eijk, AM; Ter Kuile, F; Ghani, AC; (2013) A model of parity-dependent immunity to placental malaria. Nature Communications, 4. ISSN 2041-1723 DOI: https://doi.org/10.1038/ncomms2605

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Abstract

Plasmodium falciparum placental infection during pregnancy is harmful for both mother and child. Protection from placental infection is parity-dependent, that is, acquired over consecutive pregnancies. However, the infection status of the placenta can only be assessed at delivery. Here, to better understand the mechanism underlying this parity-dependence, we fitted a model linking malaria dynamics within the general population to observed placental histology. Our results suggest that immunity resulting in less prolonged infection is a greater determinant of the parity-specific patterns than immunity that prevents placental sequestration. Our results also suggest the time when maternal blood first flows into the placenta is a high-risk period. Therefore, preventative strategies implementable before or early in pregnancy, such as insecticide-treated net usage in women of child-bearing age or any future vaccine, could substantially reduce the number of women who experience placental infection.

Item Type: Article
Keywords: falciparum-infected erythrocytes, chondroitin sulfate-a, sub-saharan, africa, plasmodium-falciparum, birth-weight, pregnancy outcomes, gestational-age, kenyan coast, anemia, transmission
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: Malaria Centre
Tropical Epidemiology Group
Web of Science ID: 318873900062
URI: http://researchonline.lshtm.ac.uk/id/eprint/1105249

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