A model of parity-dependent immunity to placental malaria

Patrick G. T. Walker (), Jamie T. Griffin, Matt Cairns, Stephen J. Rogerson, Anna M. van Eijk, Feiko ter Kuile and Azra C. Ghani
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Patrick G. T. Walker: MRC Centre for Outbreak Analysis and Modelling, Imperial College London, Norfolk Place
Jamie T. Griffin: MRC Centre for Outbreak Analysis and Modelling, Imperial College London, Norfolk Place
Matt Cairns: London School of Hygiene and Tropical Medicine
Stephen J. Rogerson: University of Melbourne, 4th Floor, Clinical Sciences Building, Royal Melbourne Hospital, Royal Parade
Anna M. van Eijk: Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Pembroke Place
Feiko ter Kuile: Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Pembroke Place
Azra C. Ghani: MRC Centre for Outbreak Analysis and Modelling, Imperial College London, Norfolk Place

Nature Communications, 2013, vol. 4, issue 1, 1-11

Abstract: Abstract Plasmodium falciparum placental infection during pregnancy is harmful for both mother and child. Protection from placental infection is parity-dependent, that is, acquired over consecutive pregnancies. However, the infection status of the placenta can only be assessed at delivery. Here, to better understand the mechanism underlying this parity-dependence, we fitted a model linking malaria dynamics within the general population to observed placental histology. Our results suggest that immunity resulting in less prolonged infection is a greater determinant of the parity-specific patterns than immunity that prevents placental sequestration. Our results also suggest the time when maternal blood first flows into the placenta is a high-risk period. Therefore, preventative strategies implementable before or early in pregnancy, such as insecticide-treated net usage in women of child-bearing age or any future vaccine, could substantially reduce the number of women who experience placental infection.

Date: 2013
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DOI: 10.1038/ncomms2605

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