Abstract
BackgroundChildren below six months are reported to be less susceptible to clinical malaria. Maternally derived antibodies and foetal haemoglobin are important putative protective factors. We examined antibodies to Plasmodium falciparum merozoite surface protein 3 (MSP3) and glutamate-rich protein (GLURP), in children in their first two years of life in Burkina Faso and their risk of malaria.MethodsA cohort of 140 infants aged between four and six weeks was recruited in a stable transmission area of south-western Burkina Faso and monitored for 24 months by active and passive surveillance. Malaria infections were detected by examining blood smears using light microscopy. Enzyme-linked immunosorbent assay was used to quantify total Immunoglobulin G to Plasmodium falciparum antigens MSP3 and two regions of GLURP (R0 and R2) on blood samples collected at baseline, three, six, nine, 12, 18 and 24 months. Foetal haemoglobin and variant haemoglobin fractions were measured at the baseline visit using high pressure liquid chromatography.ResultsA total of 79.6% of children experienced one or more episodes of febrile malaria during monitoring. Antibody titres to MSP3 were prospectively associated with an increased risk of malaria while antibody responses to GLURP (R0 and R2) did not alter the risk. Antibody titres to MSP3 were higher among children in areas of high malaria risk. Foetal haemoglobin was associated with delayed first episode of febrile malaria and haemoglobin CC type was associated with reduced incidence of febrile malaria.ConclusionsWe did not find any evidence of association between titres of antibodies to MSP3, GLURP-R0 or GLURP-R2 as measured by enzyme-linked immunosorbent assay and early protection against malaria, although anti-MSP3 antibody titres may reflect increased exposure to malaria and therefore greater risk. Foetal haemoglobin was associated with protection against febrile malaria despite the study limitations and its role is therefore worthy further investigation.
Highlights
Children under five years of age bear the majority of the malaria burden [1], infants have been shown to be less likely to develop clinical malaria within their first six months of life [2,3,4,5].This apparent protection has been linked to passive transfer of anti-malaria antibodies by earlier experimental studies [6,7,8]
We investigated three merozoite surface proteins, merozoite surface protein 3 (MSP3)-LSP and two regions of glutamate-rich protein (GLURP) (R0 and R2), as they have been used in a malaria vaccine that is currently undergoing testing [44,45]
Changing anti-MSP3 antibody titres were significantly associated with increased incidence of febrile malaria episodes (IRR = 1.17, p = 0.007, 95% CI [1.04, 1.30]), but baseline titres were not
Summary
Children under five years of age bear the majority of the malaria burden [1], infants have been shown to be less likely to develop clinical malaria within their first six months of life [2,3,4,5]. This apparent protection has been linked to passive transfer of anti-malaria antibodies by earlier experimental studies [6,7,8]. We examined antibodies to Plasmodium falciparum merozoite surface protein 3 (MSP3) and glutamate-rich protein (GLURP), in children in their first two years of life in Burkina Faso and their risk of malaria
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