Effects of Malaria Endemicity on the Development of Immunity in Kenyan Children

Snider, Cynthia

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March 22, 2019

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Snider, Cynthia
- Affiliation: Gillings School of Global Public Health, Department of Epidemiology

Abstract

The heterogeneity of Plasmodium falciparum (Pf-) malaria endemicity affords an opportunity to explore the differential effects of Pf-malaria infections on the development of immunity. Focusing on two areas in western Kenya with disparate Pf-malaria transmission intensities, this dissertation 1) examined how recurrent Pf-malaria infections affected Epstein-Barr virus (EBV) lytic and latent antigen CD8+ T-cell IFN-γ; response among EBV co-infected infected children, and 2) described the differential patterns of Pf-malaria antibody responses and how they waned over time. We analyzed data collected over a two-year time period from children residing in Kisumu (high malaria transmission) and Nandi (low malaria transmission). We observed a 46% decrease in the prevalence of positive EBV lytic antigen IFN-γ; response among children living in the Kisumu when compared to Nandi (PR: 0.54; 95% CI: 0.30-0.99). Further analysis revealed impairment of EBV lytic antigen IFN-γ; responses among 5-9 year olds. We did not identify any differences in Pf-malaria exposure and EBV latent antigen IFN-γ; response. Results suggest there may be a loss of immunological control of the EBV lytic cycle among children repeatedly infected with Pf-malaria. Our second analysis on Pf-malaria antibody responses revealed that proportions of positive IgG responses to select blood-stage antigens (apical membrane antigens-1 3D7 and FVO strains) and the pre-erythrocytic liver stage antigen-1 antigen were higher in Kisumu than Nandi (P P Pf-malaria transmission intensities and age.

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