Plasmodium falciparum infection patterns since birth and risk of severe malaria: a nested case-control study in children on the coast of Kenya

Children in malaria endemic areas acquire immunity to severe malaria faster than to mild malaria. Only a minority of children suffers from severe malaria and it is not known what determines this. The aim of this study was to establish how P. falciparum infections during the first years of life affec...

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Bibliographic Details
Published in:PloS one 2013-02, Vol.8 (2), p.e56032-e56032
Main Authors: Lundblom, Klara, Murungi, Linda, Nyaga, Victoria, Olsson, Daniel, Rono, Josea, Osier, Faith, Ogada, Edna, Montgomery, Scott, Scott, J Anthony G, Marsh, Kevin, Färnert, Anna
Format: Article
Language:English
Subjects:
Age
Anemia
Antigens
Case-Control Studies
Child, Preschool
Children
Cloning
Epidemiology
Erythrocytes
Female
Genotyping
Health risks
Hospitals
Humans
Immunity
Infant
Infection
Infections
Infectious diseases
Kenya - epidemiology
Malaria
Malaria, Falciparum - epidemiology
Malaria, Falciparum - immunology
Male
Medical research
Medicin
Medicin och hälsovetenskap
Medicine
Metabolism
Morbidity
Mortality
Parasites
Plasmodium falciparum
Plasmodium falciparum - isolation & purification
Residential location
Risk
Severity of Illness Index
Studies
Vector-borne diseases
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Summary:Children in malaria endemic areas acquire immunity to severe malaria faster than to mild malaria. Only a minority of children suffers from severe malaria and it is not known what determines this. The aim of this study was to establish how P. falciparum infections during the first years of life affect the risk of severe malaria. A matched case-control study was nested within a large birth cohort set up to study the immunoepidemiology of pneumococci on the Kenyan coast. Infection patterns in three-monthly blood samples in cohort children admitted to hospital with severe malaria were compared to controls matched on age, residential location and time of sampling. P. falciparum detected at least once from birth conferred an increased risk of severe malaria and particularly if multiclonal infections, as characterized by genotyping of a polymorphic antigen gene, were ever detected. The results show for the first time that children with severe malaria have more infections early in life compared to community controls. These findings provide important insights on the immunity to severe disease, knowledge essential for the development of a vaccine against severe malaria.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0056032