Resurgent and delayed malaria

Abstract The populations of moderate or highly malaria endemic areas gradually acquire some immunity to malaria as a result of repeated exposure to the infection. When this exposure is reduced as a result of effective malaria control measures, subjects who benefitted from the intervention may conseq...

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Main Authors: Brian Greenwood, Issaka Zongo, Alassane Dicko, Daniel Chandramohan, Robert W. Snow, Christian Ockenhouse
Format: Article
Language:English
Published: BMC 2022-03-01
Series:Malaria Journal
Subjects:
Online Access:https://doi.org/10.1186/s12936-022-04098-6
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author Brian Greenwood
Issaka Zongo
Alassane Dicko
Daniel Chandramohan
Robert W. Snow
Christian Ockenhouse
author_facet Brian Greenwood
Issaka Zongo
Alassane Dicko
Daniel Chandramohan
Robert W. Snow
Christian Ockenhouse
author_sort Brian Greenwood
collection DOAJ
description Abstract The populations of moderate or highly malaria endemic areas gradually acquire some immunity to malaria as a result of repeated exposure to the infection. When this exposure is reduced as a result of effective malaria control measures, subjects who benefitted from the intervention may consequently be at increased risk of malaria if the intervention is withdrawn, especially if this is done abruptly, and an effective malaria vector remains. There have been many examples of this occurring in the past, a phenomenon often termed ‘rebound malaria’, with the incidence of malaria rebounding to the level present before the intervention was introduced. Because the main clinical burden of malaria in areas with a high level of malaria transmission is in young children, malaria control efforts have, in recent decades, focussed on this group, with substantial success being obtained with interventions such as insecticide treated mosquito nets, chemoprevention and, most recently, malaria vaccines. These are interventions whose administration may not be sustained. This has led to concerns that in these circumstances, the overall burden of malaria in children may not be reduced but just delayed, with the main period of risk being in the period shortly after the intervention is no longer given. Although dependent on the same underlying process as classical ‘resurgent’ malaria, it may be helpful to differentiate the two conditions, describing the later as ‘delayed malaria’. In this paper, some of the evidence that delayed malaria occurs is discussed and potential measures for reducing its impact are suggested.
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spelling doaj.art-94a83e3fcd50475ab795d1073481ee082022-12-21T17:45:44ZengBMCMalaria Journal1475-28752022-03-012111510.1186/s12936-022-04098-6Resurgent and delayed malariaBrian Greenwood0Issaka Zongo1Alassane Dicko2Daniel Chandramohan3Robert W. Snow4Christian Ockenhouse5Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel StInstitut de Recherche en Science de La SantéMalaria Research and Training Centre, University of Sciences Techniques and TechnologiesFaculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel StKenya Medical Research Institute-Wellcome Trust Collaborative ProgrammePATH – Malaria Vaccine InitiativeAbstract The populations of moderate or highly malaria endemic areas gradually acquire some immunity to malaria as a result of repeated exposure to the infection. When this exposure is reduced as a result of effective malaria control measures, subjects who benefitted from the intervention may consequently be at increased risk of malaria if the intervention is withdrawn, especially if this is done abruptly, and an effective malaria vector remains. There have been many examples of this occurring in the past, a phenomenon often termed ‘rebound malaria’, with the incidence of malaria rebounding to the level present before the intervention was introduced. Because the main clinical burden of malaria in areas with a high level of malaria transmission is in young children, malaria control efforts have, in recent decades, focussed on this group, with substantial success being obtained with interventions such as insecticide treated mosquito nets, chemoprevention and, most recently, malaria vaccines. These are interventions whose administration may not be sustained. This has led to concerns that in these circumstances, the overall burden of malaria in children may not be reduced but just delayed, with the main period of risk being in the period shortly after the intervention is no longer given. Although dependent on the same underlying process as classical ‘resurgent’ malaria, it may be helpful to differentiate the two conditions, describing the later as ‘delayed malaria’. In this paper, some of the evidence that delayed malaria occurs is discussed and potential measures for reducing its impact are suggested.https://doi.org/10.1186/s12936-022-04098-6MalariaImmunityRebound malariaResurgent malariaDelayed malaria
spellingShingle Brian Greenwood
Issaka Zongo
Alassane Dicko
Daniel Chandramohan
Robert W. Snow
Christian Ockenhouse
Resurgent and delayed malaria
Malaria Journal
Malaria
Immunity
Rebound malaria
Resurgent malaria
Delayed malaria
title Resurgent and delayed malaria
title_full Resurgent and delayed malaria
title_fullStr Resurgent and delayed malaria
title_full_unstemmed Resurgent and delayed malaria
title_short Resurgent and delayed malaria
title_sort resurgent and delayed malaria
topic Malaria
Immunity
Rebound malaria
Resurgent malaria
Delayed malaria
url https://doi.org/10.1186/s12936-022-04098-6
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