Age interactions in the development of naturally acquired immunity to Plasmodium falciparum and its clinical presentation
2007

Age and Immunity to Malaria

Sample size: 415 publication 10 minutes Evidence: moderate

Author Information

Author(s): John Aponte, Clara Menendez, David Schellenberg, Elizeus Kahigwa, Hassan Mshinda, Marcel Tanner, Pedro L. Alonso

Primary Institution: Barcelona Centre for International Health Research, Hospital Clinic/IDIBAPS, Universitat de Barcelona, Barcelona, Spain

Hypothesis

How does age affect the development of immunity to Plasmodium falciparum in children?

Conclusion

Reducing exposure to P. falciparum antigens through chemoprophylaxis early in life can delay immunity acquisition.

Supporting Evidence

  • Children receiving malaria prophylaxis had fewer episodes of malaria during the first year.
  • After stopping prophylaxis, the incidence of malaria increased significantly in treated children.
  • By age 4, treated children had slightly more episodes of clinical malaria but fewer severe malaria episodes.

Takeaway

Giving young children medicine to prevent malaria can help them avoid getting sick at first, but it might make them more likely to get sick later.

Methodology

Randomized controlled trial with 415 infants receiving either malaria prophylaxis or placebo, followed for 4 years.

Potential Biases

Potential bias due to loss to follow-up and the small number of deaths recorded.

Limitations

The study's findings may be influenced by local changes in malaria transmission during the study period.

Participant Demographics

Tanzanian infants aged 2 to 12 months at the start of the study.

Statistical Information

P-Value

0.512

Confidence Interval

95% CI: −0.21 to 0.59

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1371/journal.pmed.0040242

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