Potential impact of host immunity on malaria treatment outcome in Tanzanian children infected with Plasmodium falciparum
Abstract Background In malaria endemic areas children may recover from malaria after chemotherapy in spite of harbouring genotypically drug-resistant Plasmodium falciparum . This phenomenon suggests that there is a synergy between drug treatment and acquired immunity. This hypothesis was examined in...
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ftdoajarticles:oai:doaj.org/article:30d5119415bb482e9532cda20ab81a06 2023-05-15T15:15:31+02:00 Potential impact of host immunity on malaria treatment outcome in Tanzanian children infected with Plasmodium falciparum Theander Thor G Staalsoe Trine Jensen Anja TR Vestergaard Lasse S Theisen Michael Nkya Watoky MMM Enevold Anders Bygbjerg Ib C Alifrangis Michael 2007-11-01T00:00:00Z https://doi.org/10.1186/1475-2875-6-153 https://doaj.org/article/30d5119415bb482e9532cda20ab81a06 EN eng BMC http://www.malariajournal.com/content/6/1/153 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-6-153 1475-2875 https://doaj.org/article/30d5119415bb482e9532cda20ab81a06 Malaria Journal, Vol 6, Iss 1, p 153 (2007) Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2007 ftdoajarticles https://doi.org/10.1186/1475-2875-6-153 2022-12-31T08:38:17Z Abstract Background In malaria endemic areas children may recover from malaria after chemotherapy in spite of harbouring genotypically drug-resistant Plasmodium falciparum . This phenomenon suggests that there is a synergy between drug treatment and acquired immunity. This hypothesis was examined in an area of moderately intense transmission of P. falciparum in Tanzania during a drug trail with sulphadoxine-pyrimethamine (SP) or amodiaquine (AQ). Methods One hundred children with uncomplicated malaria were treated with either SP or AQ and followed for 28 days. Mutations in parasite genes related to SP and AQ-resistance as well as human sickle cell trait and alpha-thalassaemia were determined using PCR and sequence-specific oligonucleotide probes and enzyme-linked immunosorbent assay (SSOP-ELISA), and IgG antibody responses to a panel of P. falciparum antigens were assessed and related to treatment outcome. Results Parasitological or clinical treatment failure (TF) was observed in 68% and 38% of children receiving SP or AQ, respectively. In those with adequate clinical and parasitological response (ACPR) compared to children with TF, and for both treatment regimens, prevalence and levels of anti-Glutamate-rich Protein (GLURP)-specific IgG antibodies were significantly higher (P < 0.001), while prevalence of parasite haplotypes associated with SP and AQ resistance was lower (P = 0.02 and P = 0.07, respectively). Interestingly, anti-GLURP-IgG antibodies were more strongly associated with treatment outcome than parasite resistant haplotypes, while the IgG responses to none of the other 11 malaria antigens were not significantly associated with ACPR. Conclusion These findings suggest that GLURP-specific IgG antibodies in this setting contribute to clearance of drug-resistant infections and support the hypothesis that acquired immunity enhances the clinical efficacy of drug therapy. The results should be confirmed in larger scale with greater sample size and with variation in transmission intensity. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Sickle ENVELOPE(-66.783,-66.783,-68.867,-68.867) Malaria Journal 6 1 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
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Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Theander Thor G Staalsoe Trine Jensen Anja TR Vestergaard Lasse S Theisen Michael Nkya Watoky MMM Enevold Anders Bygbjerg Ib C Alifrangis Michael Potential impact of host immunity on malaria treatment outcome in Tanzanian children infected with Plasmodium falciparum |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background In malaria endemic areas children may recover from malaria after chemotherapy in spite of harbouring genotypically drug-resistant Plasmodium falciparum . This phenomenon suggests that there is a synergy between drug treatment and acquired immunity. This hypothesis was examined in an area of moderately intense transmission of P. falciparum in Tanzania during a drug trail with sulphadoxine-pyrimethamine (SP) or amodiaquine (AQ). Methods One hundred children with uncomplicated malaria were treated with either SP or AQ and followed for 28 days. Mutations in parasite genes related to SP and AQ-resistance as well as human sickle cell trait and alpha-thalassaemia were determined using PCR and sequence-specific oligonucleotide probes and enzyme-linked immunosorbent assay (SSOP-ELISA), and IgG antibody responses to a panel of P. falciparum antigens were assessed and related to treatment outcome. Results Parasitological or clinical treatment failure (TF) was observed in 68% and 38% of children receiving SP or AQ, respectively. In those with adequate clinical and parasitological response (ACPR) compared to children with TF, and for both treatment regimens, prevalence and levels of anti-Glutamate-rich Protein (GLURP)-specific IgG antibodies were significantly higher (P < 0.001), while prevalence of parasite haplotypes associated with SP and AQ resistance was lower (P = 0.02 and P = 0.07, respectively). Interestingly, anti-GLURP-IgG antibodies were more strongly associated with treatment outcome than parasite resistant haplotypes, while the IgG responses to none of the other 11 malaria antigens were not significantly associated with ACPR. Conclusion These findings suggest that GLURP-specific IgG antibodies in this setting contribute to clearance of drug-resistant infections and support the hypothesis that acquired immunity enhances the clinical efficacy of drug therapy. The results should be confirmed in larger scale with greater sample size and with variation in transmission intensity. |
format |
Article in Journal/Newspaper |
author |
Theander Thor G Staalsoe Trine Jensen Anja TR Vestergaard Lasse S Theisen Michael Nkya Watoky MMM Enevold Anders Bygbjerg Ib C Alifrangis Michael |
author_facet |
Theander Thor G Staalsoe Trine Jensen Anja TR Vestergaard Lasse S Theisen Michael Nkya Watoky MMM Enevold Anders Bygbjerg Ib C Alifrangis Michael |
author_sort |
Theander Thor G |
title |
Potential impact of host immunity on malaria treatment outcome in Tanzanian children infected with Plasmodium falciparum |
title_short |
Potential impact of host immunity on malaria treatment outcome in Tanzanian children infected with Plasmodium falciparum |
title_full |
Potential impact of host immunity on malaria treatment outcome in Tanzanian children infected with Plasmodium falciparum |
title_fullStr |
Potential impact of host immunity on malaria treatment outcome in Tanzanian children infected with Plasmodium falciparum |
title_full_unstemmed |
Potential impact of host immunity on malaria treatment outcome in Tanzanian children infected with Plasmodium falciparum |
title_sort |
potential impact of host immunity on malaria treatment outcome in tanzanian children infected with plasmodium falciparum |
publisher |
BMC |
publishDate |
2007 |
url |
https://doi.org/10.1186/1475-2875-6-153 https://doaj.org/article/30d5119415bb482e9532cda20ab81a06 |
long_lat |
ENVELOPE(-66.783,-66.783,-68.867,-68.867) |
geographic |
Arctic Sickle |
geographic_facet |
Arctic Sickle |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 6, Iss 1, p 153 (2007) |
op_relation |
http://www.malariajournal.com/content/6/1/153 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-6-153 1475-2875 https://doaj.org/article/30d5119415bb482e9532cda20ab81a06 |
op_doi |
https://doi.org/10.1186/1475-2875-6-153 |
container_title |
Malaria Journal |
container_volume |
6 |
container_issue |
1 |
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1766345890150219776 |