11. Premunition in Plasmodium falciparum infection: insights from the epidemiology of multiple infections

作者：Thomas A. Smith, Ingrid Felger, Marcel Tanner, Hans‐Peter Beck · 发表于：Transactions of the Royal Society of Tropical Medicine and Hygiene · 年份：1999 · DOI：10.1016/s0035-9203(99)90329-2 · 被引用次数：220 · 研究领域：Malaria Research and Control、Mosquito-borne diseases and control、Vector-borne infectious diseases

Epidemiological studies of multiple clone infections by Plasmodium falciparum in highly endemic areas have demonstrated age dependence in both the multiplicity of infection and the relationships between this multiplicity and the risk of acute illness. We hypothesize that, in infants, host defence against blood-stage infections with P. falciparum relies mainly on fever and cytokine activities, and the infections are of short duration. In older children, a high multiplicity of infection is characteristic of low-level chronic parasitaemia. This appears to confer cross-protection against newly inoculated parasites, via partially genotype-specific responses which are short-term, lasting little longer than the infections themselves. This has important implications for our understanding of immunity against P. falciparum, its ecological niche, and the epidemiological impact of interventions against it.