Immunological consequences of intermittent preventive treatment against malaria in Senegalese preschool children

• Published in: Malaria journal 2010-12, Vol.9 (1), p.363-363, Article 363
• Main Authors: Boulanger, Denis, Sarr, Jean Biram, Fillol, Florie, Sokhna, Cheikh, Cisse, Badara, Schacht, Anne-Marie, Trape, Jean-François, Riveau, Gilles, Simondon, François, Greenwood, Brian, Remoué, Franck
• Format: Article
• Language: English
• Subjects: Age; Analysis; Anemia; Antibodies, Protozoan - blood; Antimalarials - administration & dosage; Artemisinins - administration & dosage; Artesunate; Asexuality; Chemoprevention - methods; Child, Preschool; Children; Disease susceptibility; Drug Combinations; Drug therapy; Epidemiology; Female; Gender; Genetic aspects; Health aspects; Hemoglobin; Human diseases; Humans; Immune response (humoral); Immunity; Immunoglobulin G; Immunoglobulin G - blood; Immunology; Infant; Malaria; Malaria - immunology; Malaria - prevention & control; Male; Morbidity; Nutritional status; Parasites; Placebos - administration & dosage; Plasmodium; Plasmodium falciparum; Plasmodium falciparum - immunology; Pyrimethamine; Pyrimethamine - administration & dosage; Senegal; Studies; Sulfadoxine - administration & dosage; Towns; Vector-borne diseases
• ISSN: 1475-2875; 1475-2875
• DOI: 10.1186/1475-2875-9-363

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. 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. 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. 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.