Immunity to non-cerebral severe malaria is acquired after one or two infections
Immunity to non-cerebral severe malaria is acquired after one or two infections
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DOI：
10.1038/6560
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发表时间：
1999-03-01
期刊：
影响因子：
82.9
通讯作者：
Newbold, C
中科院分区：
文献类型：
--
作者：
Gupta, S;Snow, RW;Newbold, C
在传播稳定的地区，对轻度疟疾的临床免疫力获得缓慢，因此通常要到青春期早期才有效。然而，危及生命的疾病仅限于更年轻的年龄组，这表明对感染的严重临床后果的抵抗力更快。了解对严重疟疾的免疫力发展速度有多快至关重要，因为严重疟疾应该是干预策略的主要目标，并且预测减少宿主暴露的干预措施的结果将需要考虑这些动态(1,2)。在传播最严重的地区，儿童期严重疾病的发生率较低(3)。对此的一种解释是，婴儿在受到母体抗体保护免受疾病侵害的同时，接触感染的机会增加(4-6)。因此，他们在这段临床保护期后比那些传播强度较低的人具有更高的免疫力。在这里，我们使用这些数据(3)，假设有一段临床保护期，来估计将严重疾病的风险降低到可以忽略不计的水平所需的先前感染数量。与预期相反，在广泛的传播强度范围内，一两次成功的感染性叮咬似乎就足够了。
In areas of stable transmission, clinical immunity to mild malaria is acquired slowly, so it is not usually effective until early adolescence. Life-threatening disease is, however, restricted to a much younger age group, indicating that resistance to the severe clinical consequences of infection is acquired more quickly. Understanding how rapidly immunity develops to severe malaria is essential, as severe malaria should be the primary target of intervention strategies, and predicting the result of interventions that reduce host exposure will require consideration of these dynamics(1,2). Severe disease in childhood is less frequent in areas where transmission is the greatest(3). One explanation for this is that infants experience increased exposure to infection(4-6) while they are protected from disease, possibly by maternal antibody. They therefore emerge from this period of clinical protection with considerably more immunity than those who experience lower transmission intensities. Here we use this data(3), assuming a period of clinical protection, to estimate the number of prior infections needed to reduce the risk of severe disease to negligible levels. Contrary to expectations, one or two successful infective bites seem to be all that is necessary across a broad range of transmission intensities.