A prospective study of Plasmodium falciparum multiplicity of infection and morbidity in Tanzanian children


Henning, L; Schellenberg, D; Smith, T; Henning, D; Alonso, P; Tanner, M; Mshinda, H; Beck, HP; Felger, I; (2004) A prospective study of Plasmodium falciparum multiplicity of infection and morbidity in Tanzanian children. Transactions of the Royal Society of Tropical Medicine and Hygiene, 98 (12). pp. 687-694. ISSN 0035-9203 DOI: 10.1016/j.trstmh.2004.03.010

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Abstract

Several studies suggest that in individuals with substantial previous exposure to malaria, co-infection with multiple clones of Plasmodium falciparum can protect against subsequent clinical malaria attacks. Other studies, mainly of individuals with little previous exposure, found the converse relationship. To test whether acquisition of such cross-protection tracks the acquisition of clinical immunity in general, 610 Tanzanian children aged 0-6 years were enrolled in a nine-month prospective study of the risk of morbidity in relation to parasitological status and merozoite surface protein 2 genotypes on enrolment. Prevalence of parasitaemia and multiplicity of infection increased with age. In the first year of life, the incidence of clinical malaria was almost three times higher in children with parasites at baseline than in those without. In older children, baseline P. falciparum infections appeared to protect against both parasitaemic and non-parasitaemic fever episodes. In children aged less than three years, baseline multiple infection tended to be associated with higher prospective risk of clinical malaria than single infection while in children aged more than three years the converse was found, but these effects were not statistically significant. These results provide further evidence that relationships between asymptomatic malaria infections and clinical malaria change with cumulative exposure.

Item Type: Article
Keywords: Age Distribution, Animals, Antigens, Protozoan, Child, Child, Preschool, Female, Genetic Markers, Genotype, Humans, Incidence, Infant, Malaria, Falciparum, Male, Morbidity, Parasitemia, Plasmodium falciparum, Prevalence, Prospective Studies, Protozoan Proteins, Risk Factors, Tanzania, Age Distribution, Animals, Antigens, Protozoan, genetics, Child, Child, Preschool, Female, Genetic Markers, genetics, Genotype, Humans, Incidence, Infant, Malaria, Falciparum, epidemiology, immunology, parasitology, Male, Morbidity, Parasitemia, epidemiology, immunology, Plasmodium falciparum, genetics, Prevalence, Prospective Studies, Protozoan Proteins, genetics, Risk Factors, Tanzania, epidemiology
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Disease Control
Research Centre: Malaria Centre
Centre for Maternal, Reproductive and Child Health (MARCH)
PubMed ID: 15485698
Web of Science ID: 224900600001
URI: http://researchonline.lshtm.ac.uk/id/eprint/8869

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