Effect of 4 years of seasonal malaria chemoprevention on the acquisition of antibodies to Plasmodium falciparum antigens in Ouelessebougou, Mali

• Published in: Malaria journal 2021-01, Vol.20 (1), p.23-23, Article 23
• Main Authors: Mahamar, Almahamoudou, Issiaka, Djibrilla, Youssouf, Ahamadou, Niambele, Sidi M, Soumare, Harouna M, Attaher, Oumar, Barry, Amadou, Narum, David L, Duffy, Patrick E, Greenwood, Brian, Fried, Michal, Dicko, Alassane
• Format: Article
• Language: English
• Subjects: Age; AMA1; Amodiaquine; Antibodies; Antibody to MSP-142; Antigens; Antimalarial agents; Care and treatment; Chemoprevention; Children; CSP; Disease transmission; ELISA; Evaluation; Health aspects; Human diseases; Immunoglobulin G; Malaria; Parasites; Plasmodium falciparum; Properties; Pyrimethamine; Seasonal malaria chemoprevention; Seasons; Seropositivity; Sulfadoxine; Surveying; Vector-borne diseases
• ISSN: 1475-2875; 1475-2875
• DOI: 10.1186/s12936-020-03542-9

More than 200 million people live in areas of highly seasonal malaria transmission where Seasonal Malaria Chemoprevention (SMC) with sulfadoxine-pyrimethamine (SP) and amodiaquine (AQ) was recommended in 2012 by WHO. This strategy is now implemented widely and protected more than 19 million children in 2018. It was previously reported that exposure to SMC reduced antibody levels to AMA1, MSP-1  and CSP, but the duration of exposure to SMC up to three 3 years, had no effect on antibody levels to MSP-1  and CSP. In 2017, a cross-sectional survey was carried out 1 month after the last dose of SMC had been given to children aged 4-5 years randomly selected from areas where SMC had been given for 2 or 4 years during the malaria transmission season. A total of 461 children were enrolled, 242 children in areas where SMC had been implemented for 4 years and 219 children in areas where SMC had been implemented for 2 years. Antibody extracted from dry blood spots was used to measure IgG levels to the malaria antigens CSP, MSP-1  and AMA1 by ELISA. The prevalence of antibodies to MSP-1  was similar in children who had received SMC for 4 years compared to those who had received SMC for only 2 years (85.1 vs 86.0%, ajusted odd ratio (aOR) = 1.06, 95% confidence intervals (CI 0.62-1.80), p = 0.80). The prevalence of antibodies to AMA-1 and to CSP was not lower in children who received SMC for 4 years compared to those who had received SMC for only 2 years (95.3 vs 88.8%, aOR = 3.16, 95% CI 1.44-6.95, p = 0.004 for AMA-1; and 91.2 vs 81.9%, aOR = 3.14, 95% CI 1.70-5.76, p