A model of parity-dependent immunity to placental malaria.
Walker, Patrick GT;
Griffin, Jamie T;
Cairns, Matt;
Rogerson, Stephen J;
van Eijk, Anna M;
ter Kuile, Feiko;
Ghani, Azra C;
(2013)
A model of parity-dependent immunity to placental malaria.
Nature communications, 4 (1).
1609-.
ISSN 2041-1723
DOI: https://doi.org/10.1038/ncomms2605
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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.