Antibody responses to plasmodium falciparum and plasmodium vivax and prospective risk of plasmodium spp. Infection postpartum

Alistair R.D. McLean, MacHteld Boel, Rose McGready, Ricardo Ataide, Damien R Drew, Takafumi Tsuboi, James G. Beeson, François Nosten, Julie A. Simpson, Freya J.I. Fowkes

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Postpartum women may have an altered susceptibility to Plasmodium falciparum and Plasmodium vivax. The relationship between naturally acquired malarial immunity and susceptibility to malaria postpartum is yet to be determined. IgG levels were measured against P. falciparum and P. vivax antigens from delivery in 201 postpartum and 201 nonpregnant controls over 12 weeks. Associations between time-varying antibody levels and time to first microscopically confirmed species-specific infection were determined by Cox regression. Associations between antibody levels and prospective risk of Plasmodium infection were similar in postpartum and control women. A 2-fold increase in P. falciparum antibody levels was associated with increased prospective risk of P. falciparum infection (hazard ratio [HR] range = 1.37-1.94). Antibody levels against most P. vivax antigens displayed no association with prospective risk of P. vivax infection (HR range = 1.02-1.05) with the exception of PvMSP119 antibodies that were weakly associated with prospective risk of P. vivax infection (HR = 1.14 (95% confidence interval = 1.02, 1.28) per 2-fold increase in levels). Associations between antibody levels and prospective risk of infection attenuated when adjusted for documented retrospective exposure. Serology may be a useful tool to predict and monitor women at increased risk of P. falciparum infection postpartum, particularly in the absence of a detailed history of retrospective infections.

Original languageEnglish
Pages (from-to)1197-1204
Number of pages8
JournalThe American Journal of Tropical Medicine and Hygiene
Issue number5
Publication statusPublished - May 2017

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