The risk of malarial infections and disease in Papua New Guinean children

Pascal Michon, Jennifer L. Cole-Tobian, Elijah Dabod, Sonja Schoepflin, Jennifer Igu, Melinda Susapu, Nandao Tarongka, Peter A. Zimmerman, John C. Reeder, James G. Beeson, Louis Schofield, Christopher L. King, Ivo Mueller

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132 Citations (Scopus)


In a treatment re-infection study of 206 Papua New Guinean school children, we examined risk of reinfection and symptomatic malaria caused by different Plasmodium species. Although children acquired a similar number of polymerase chain reaction-detectable Plasmodium falciparum and P. vivax infections in six months of active follow-up (P. falciparum = 5.00, P. vivax = 5.28), they were 21 times more likely to develop symptomatic P. falciparum malaria (1.17/year) than P. vivax malaria (0.06/year). Children greater than nine years of age had a reduced risk of acquiring P. vivax infections of low-to-moderate (>150/μL) density (adjusted hazard rate [AHR] = 0.65 and 0.42), whereas similar reductions in risk with age of P. falciparum infection was only seen for parasitemias > 5,000/μL (AHR = 0.49) and symptomatic episodes (AHR = 0.51). Infection and symptomatic episodes with P. malariae and P. ovale were rare. By nine years of age, children have thus acquired almost complete clinical immunity to P. vivax characterized by a very tight control of parasite density, whereas the acquisition of immunity to symptomatic P. falciparum malaria remained incomplete. These observations suggest that different mechanisms of immunity may be important for protection from these malaria species.

Original languageEnglish
Pages (from-to)997-1008
Number of pages12
JournalThe American Journal of Tropical Medicine and Hygiene
Issue number6
Publication statusPublished - 1 Jun 2007
Externally publishedYes

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