Oh. Branch et al., Plasmodium falciparum genotypes, low complexity of infection, and resistance to subsequent malaria in participants in the Asembo Bay cohort project, INFEC IMMUN, 69(12), 2001, pp. 7783-7792
To assess the relationship between the within-host diversity of malaria inf
ections and the susceptibility of the host to subsequent infection, we geno
typed 60 children's successive infections from birth through 3 years of lif
e. MSP-1 Block2 genotypes were used to estimate the complexity of infection
(COI). Malaria transmission and age were positively associated with the nu
mber of K1 and Mad20 alleles detected (COIKM) (P < 0.003). Controlling for
previous parasitemia, transmission, drug treatment, parasite density, sickl
e cell, and age, COIKM was negatively correlated with resistance to parasit
emia of > 500/mul (P < 0.0001). Parasitemias with the RO-genotype were more
resistant than those without this genotype (P < 0.0000). The resistance in
low COIKM infections was not genotype specific. We discuss the impact of g
enotype-transcending immunity to conserved antigenic determinants. We also
propose a diversity-driven immunomodulation hypothesis that may explain the
delayed development of natural immunity in the first few years of life and
suggest that interventions that decrease the COIKM could facilitate the de
velopment of protective immunity.