Differential Patterns of Infection and Disease with P. falciparum and P. vivax in Young Papua New Guinean Children

被引：116

作者：

Lin, Enmoore ^{[1
]}

Kiniboro, Benson ^{[1
]}

Gray, Laurie ^{[2
]}

Dobbie, Stuart ^{[1
]}

Robinson, Leanne ^{[3
,4
]}

Laumaea, Annemarie ^{[1
]}

Schoepflin, Sonja ^{[5
]}

Stanisic, Danielle ^{[1
,3
]}

Betuela, Inoni ^{[1
]}

Blood-Zikursh, Melinda ^{[2
]}

Siba, Peter ^{[1
]}

Felger, Ingrid ^{[5
]}

Schofield, Louis ^{[3
]}

Zimmerman, Peter ^{[2
]}

Mueller, Ivo ^{[1
]}

机构：

[1] PNG Inst Med Res, Madang, Papua N Guinea

[2] Case Western Reserve Univ, Ctr Global Hlth & Dis, Cleveland, OH 44106 USA

[3] Walter & Eliza Hall Inst Med Res, Parkville, Vic, Australia

[4] Univ Melbourne, Dept Med Biol, Melbourne, Australia

[5] Swiss Trop Inst, CH-4002 Basel, Switzerland

来源：

PLOS ONE | 2010年 / 5卷 / 02期

基金：

瑞士国家科学基金会; 英国医学研究理事会; 美国国家卫生研究院;

关键词：

DUFFY-BINDING-PROTEIN; EAST SEPIK PROVINCE; PLASMODIUM-VIVAX; RETROSPECTIVE EXAMINATION; ANTIGENIC VARIATION; ACQUIRED-IMMUNITY; MALARIA PARASITES; CLINICAL IMMUNITY; KAREN POPULATION; SURFACE-ANTIGENS;

D O I：

10.1371/journal.pone.0009047

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

Background: Where P. vivax and P. falciparum occur in the same population, the peak burden of P. vivax infection and illness is often concentrated in younger age groups. Experiences from malaria therapy patients indicate that immunity is acquired faster to P. vivax than to P. falciparum challenge. There is however little prospective data on the comparative risk of infection and disease from both species in young children living in co-endemic areas. Methodology/Principal Findings: A cohort of 264 Papua New Guinean children aged 1-3 years (at enrolment) were actively followed-up for Plasmodium infection and febrile illness for 16 months. Infection status was determined by light microscopy and PCR every 8 weeks and at each febrile episode. A generalised estimating equation (GEE) approach was used to analyse both prevalence of infection and incidence of clinical episodes. A more pronounced rise in prevalence of P. falciparum compared to P. vivax infection was evident with increasing age. Although the overall incidence of clinical episodes was comparable (P. falciparum: 2.56, P. vivax 2.46 episodes / child / yr), P. falciparum and P. vivax infectious episodes showed strong but opposing age trends: P. falciparum incidence increased until the age of 30 months with little change thereafter, but incidence of P. vivax decreased significantly with age throughout the entire age range. For P. falciparum, both prevalence and incidence of P. falciparum showed marked seasonality, whereas only P. vivax incidence but not prevalence decreased in the dry season. Conclusions/Significance: Under high, perennial exposure, children in PNG begin acquiring significant clinical immunity, characterized by an increasing ability to control parasite densities below the pyrogenic threshold to P. vivax, but not to P. falciparum, in the 2(nd) and 3(rd) year of life. The ability to relapse from long-lasting liver-stages restricts the seasonal variation in prevalence of P. vivax infections.

引用

页数：15