Antibodies to plasmodium falciparum erythrocyte-binding antigen-175 are associated with protection from clinical malaria

Matthew B. McCarra, George Ayodo, Peter O. Sumba, James W. Kazura, Ann M. Moormann, David L. Narum, Chandy C. John

Research output: Contribution to journalArticle

25 Scopus citations

Abstract

Background: Antibodies to blood-stage Plasmodium falciparum antigens have been associated with protection against clinical malaria in some studies but not others. Many of these studies have not assessed whether high-titer antibodies are associated with protection and have not adjusted for differences in malaria exposure. Methods: The presence of high-titer antibodies to apical membrane antigen-1, erythrocyte-binding antigen-175 (EBA-175), and merozoite surface protein-119 (MSP-119) was assessed in 87 children living in a malaria holoendemic area of Kenya. The children were prospectively assessed during 1 year for clinical malaria. Results: In unadjusted analyses, high-titer antibodies to MSP-119, but not EBA-175 or apical membrane antigen-1, were associated with protection from clinical malaria. However, after adjustment for exposure, only high-titer antibodies to EBA-175 were associated with protection from clinical malaria (hazard ratio, 0.48; 95% confidence interval [CI], 0.24, 0.95; P = 0.03), and with reduced episodes of clinical malaria (incidence rate ratio, 0.50; 95% CI, 0.31, 0.81; P = 0.005). A trend toward increased protection from clinical malaria in children was seen with antibodies to both EBA-175 and MSP-119 (hazard ratio, 0.26; 95% CI, 0.03, 1.94; P = 0.18). CONCLUSIONS:: High-titer antibodies to EBA-175 are associated with protection from clinical malaria in children in a malaria holoendemic area of Kenya. Accurate estimates of antibody-associated protection from clinical malaria require adjustment for malaria exposure.

Original languageEnglish (US)
Pages (from-to)1037-1042
Number of pages6
JournalPediatric Infectious Disease Journal
Volume30
Issue number12
DOIs
StatePublished - Dec 1 2011
Externally publishedYes

Keywords

  • EBA-175
  • children
  • holoendemic
  • malaria

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)
  • Infectious Diseases

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