IMMUNOLOGICAL MARKERS OF CHILDHOOD FEVERS IN AN AREA OF INTENSE AND PERENNIAL MALARIA TRANSMISSION

In order to describe presumed paediatric malaria on a cell-immunologic al basis, the soluble receptors of IL-2 (sIL-2R) and tumour necrosis f actor (sTNF-R55 and sTNF-R75) were quantified in highly exposed young Tanzanian children. Sera were obtained from 66 acute and 72 reported f ebrile patients during health post consultations and follow-ups and fr om 68 community controls. Levels of sIL-2R, sTNF-R55 and sTNF-R75 were significantly elevated during fever attacks, especially in very young children. Soluble TNF-R75 levels were most stable and those of sTNF-R 55 least. Levels of sTNF-R55 were related to the magnitude of fever an d thus appeared to reflect attack severity. Levels of sTNF-R75 were hi ghly significantly associated with parasite density, indicating that t his response is malaria-specific. The present study indicates that sTN F-R75 levels could become a useful immunological tool in malaria inter vention studies, as they reflect changes in malaria-specific immune re sponses. Future studies should validate this potential in different en demic settings.