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Journal article

Acquired immunity to malaria.

Abstract:
Naturally acquired immunity to falciparum malaria protects millions of people routinely exposed to Plasmodium falciparum infection from severe disease and death. There is no clear concept about how this protection works. There is no general agreement about the rate of onset of acquired immunity or what constitutes the key determinants of protection; much less is there a consensus regarding the mechanism(s) of protection. This review summarizes what is understood about naturally acquired and experimentally induced immunity against malaria with the help of evolving insights provided by biotechnology and places these insights in the context of historical, clinical, and epidemiological observations. We advocate that naturally acquired immunity should be appreciated as being virtually 100% effective against severe disease and death among heavily exposed adults. Even the immunity that occurs in exposed infants may exceed 90% effectiveness. The induction of an adult-like immune status among high-risk infants in sub-Saharan Africa would greatly diminish disease and death caused by P. falciparum. The mechanism of naturally acquired immunity that occurs among adults living in areas of hyper- to holoendemicity should be understood with a view toward duplicating such protection in infants and young children in areas of endemicity.
Publication status:
Published

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Publisher copy:
10.1128/cmr.00025-08

Authors


More by this author
Institution:
University of Oxford
Division:
MSD
Department:
NDM
Sub department:
Tropical Medicine
Role:
Author


Journal:
Clinical microbiology reviews More from this journal
Volume:
22
Issue:
1
Pages:
13-36
Publication date:
2009-01-01
DOI:
EISSN:
1098-6618
ISSN:
0893-8512


Language:
English
Keywords:
Pubs id:
pubs:40998
UUID:
uuid:50bb73b5-35d2-4855-9fbd-092140804312
Local pid:
pubs:40998
Source identifiers:
40998
Deposit date:
2012-12-19

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