Plasmodium falciparum malaria: Some epidemiological implications of parasite and host diversity
Plasmodium falciparum malaria: Some epidemiological implications of parasite and host diversity
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DOI：
10.1080/00034983.1996.11813067
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发表时间：
1996-08-01
影响因子：
--
通讯作者：
Molineaux, L
中科院分区：
文献类型：
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作者：
Molineaux, L
关于以下方面的观察越来越多：（1）恶性疟原虫的抗原多样性;（2）人类宿主遗传免疫能力的多样性;（3）这些疾病与疾病、保护和确定的免疫反应之间的联系;以及（4）在宿主-寄生虫相互作用的不同阶段获得保护的可能机制。这些观察结果导致了对疾病分布、获得保护和疫苗接种前景的猜测。对后者的猜测各不相同，从悲观主义者认为有可能开发出一种疫苗，保护大多数人免受大多数寄生虫的侵害，到乐观主义者认为当地的恶性疟原虫种群由几个离散的亚群组成。如果这一假设是正确的，它可能是可能的，以防止最严重的疾病与窄谱疫苗接种对少数致命的亚群，或传播可能会中断一个相对较低的覆盖率的广谱疫苗。它的可验证性和可测试性被认为是，以及它的一些影响，规划和解释的流行病学调查和干预试验，并可能为选择抗原列入疫苗。
Observations are accumulating concerning: (1) the antigenic diversity of Plasmodium falciparum; (2) the diversity of the genetic immune-competence of human hosts; (3) the associations between these diversities and disease, protection and defined immune responses; and (4) the possible mechanisms of acquired protection at different steps of the host-parasite interaction. These observations have led to speculations concerning the distribution of disease, the acquisition of protection, and vaccination prospects. Speculations on the latter have varied from pessimism about the possibility of developing a vaccine that would protect most people against most parasites, to optimism based on the hypothesis that a local P. falciparum population is composed of a few discrete subpopulations. If this hypothesis is correct, it may be possible to prevent most severe disease with a narrow-spectrum vaccination against a virulent minority of the subpopulations, or transmission could be interrupted by a relatively low coverage of a broad-spectrum vaccination.A conceptual model that might accommodate the observations is outlined. Its plausibility and testability are considered, as well as some of its implications for the planning and interpretation of epidemiological surveys and intervention trials, and perhaps for selection of antigens for inclusion in vaccines.