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As part of a community-based group-randomized trial on the impact of permethrin-treated bed nets (ITNs) on malaria in pregnancy in a holoendemic area of western Kenya, we assessed their effects on antibody responses to Plasmodium falciparum pre-erythrocytic antigens (recombinant circumsporozoite protein [CSP] and peptides complimentary to the repeat region of the liver stage antigen-1 [LSA-1]) and blood stage antigen (recombinant C-terminal domain of the merozoite surface protein-1 [MSP-119 kD]) in paired maternal/cord plasma samples obtained from 296 deliveries (157 from ITN villages and 139 control villages). Levels of total IgG and IgG subclasses 1–3 to LSA-1 and total IgG and IgG3 to MSP-1 were lower, whereas those of total IgG to CSP were significantly higher in women from ITN villages than those from control villages. In cord plasma, levels of total IgG and IgG2 to LSA-1 and IgG3 to MSP-1 were lower in ITN villages than in control villages, but antibody responses to CSP were similar. Our results suggest that the use of ITNs decreases antibody responses to LSA-1 and MSP-1 antigens in pregnant women with associated reductions in levels of the same antibodies in cord blood. In contrast, ITN use was found to be associated with increased antibody responses to CSP in pregnant women, but had no effect on antibody levels to CSP in cord blood.
Acknowledgments: We thank the people of Rarieda Division and all the field workers who made this study possible. We are grateful to Philip Onyona, Franklin Komino, Patroba Anyona, Thomas Otieno and Malachi Ogalo for technical assistance. We express our gratitude to Dr. David Lanar (Walter Reed Army Institute of Research, Silver Springs, MD) and Dr. David Kaslow (National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD) for the kind donation of recombinant CSP and MSP-1 antigens, respectively. We thank Dr. Victor Tsang (Centers for Disease Control and Prevention, Atlanta, GA) for providing us mouse anti-human IgG subclass monoclonal antibodies. We acknowledge Dr. Laurence Slutsker (Director, Centers for Disease Control and Prevention/Kenya Medical Research Institute Research Station, Kisumu, Kenya) and Dr. Richard Steketee (Centers for Disease Control and Prevention, Atlanta, GA) for reviewing this manuscript. We also thank the Director of the Kenya Medical Research Institute for his permission to publish this paper.
Financial support: The ITN project was funded by the United States Agency for International Development. The laboratory work was supported by the UNDP/World Bank/World Health Organization/Special Program for Research and Training in Tropical Diseases. Feiko O. ter Kuile and Dianne J. Terlouw were partially supported by a grant from the Netherlands Foundation for the Advancement of Tropical Research (WOTRO) (The Hague, The Netherlands). Kathleen Wannemuehler was supported in part by an appointment to the research participation program at the Centers for Disease Control and Prevention that was administered by the Oak Ridge Institute for Science and Education through an interagency agreement between the U.S. Department of Energy and the Centers for Disease Control and Prevention.
Disclaimer: The opinions or assertions contained in this manuscript are the private ones of the authors and are not to be construed as official or reflecting the views of the U.S. Public Health Service or Department of Health and Human Services. Use of trade names is for identification only and does not imply endorsement by the U.S. Public Health Service or Department of Health and Human Services.
Authors’ addresses: Simon K. Kariuki, Centre for Vector Biology and Control Research, Kenya Medical Research Institute, PO Box 1578, Kisumu, Kenya. Feiko O. ter Kuile, Kathleen Wannemuehler, Dianne J. Terlouw, Margarette S. Kolczak, William A. Hawley, Penelope A. Phillips-Howard, Altaf A. Lal, and Ya Ping Shi, Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Mailstop F-22, 4770 Buford Highway, Atlanta, GA 30341. Alloys SS. Orago, Zoology Department, Kenyatta University, PO Box 43844, Nairobi, Kenya. Bernard L. Nahlen, Roll Back Malaria, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland.
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