Plasmodium falciparum Genotypes, Low Complexity of Infection, and Resistance to Subsequent Malaria in Participants in the Asembo Bay Cohort Project

Author:

Branch Oralee H.12,Takala Shannon1,Kariuki Simon3,Nahlen Bernard L.1,Kolczak Margaret1,Hawley William1,Lal Altaf A.1

Affiliation:

1. Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention,1 and

2. Emory University,2 Atlanta, Georgia, and

3. Vector Biology and Control Research Center, Kenya Medical Research Institute, Kisumu, Kenya3

Abstract

ABSTRACT To assess the relationship between the within-host diversity of malaria infections and the susceptibility of the host to subsequent infection, we genotyped 60 children's successive infections from birth through 3 years of life. MSP-1 Block2 genotypes were used to estimate the complexity of infection (COI). Malaria transmission and age were positively associated with the number of K1 and Mad20 alleles detected (COI KM ) ( P < 0.003). Controlling for previous parasitemia, transmission, drug treatment, parasite density, sickle cell, and age, COI KM was negatively correlated with resistance to parasitemia of >500/μl ( P < 0.0001). Parasitemias with the RO-genotype were more resistant than those without this genotype ( P < 0.0000). The resistance in low COI KM infections was not genotype specific. We discuss the impact of genotype-transcending immunity to conserved antigenic determinants. We also propose a diversity-driven immunomodulation hypothesis that may explain the delayed development of natural immunity in the first few years of life and suggest that interventions that decrease the COI KM could facilitate the development of protective immunity.

Publisher

American Society for Microbiology

Subject

Infectious Diseases,Immunology,Microbiology,Parasitology

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