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Among populations living in areas endemic for malaria, repeated parasite exposure leads to a gradual increase in protective immunity to the disease. In contrast, this immunity is assumed to disappear after several years of non-exposure. This study was designed to investigate long-term immunity in subjects removed from the risk of exposure. Plasmodium falciparum malaria attacks occurring after short trips to sub-Saharan Africa were compared between 99 European patients and 252 African immigrants who had been resident in Europe for at least four years. Relative to the European patients, those originating from Africa had lower mean ± SD parasite densities (0.8 ± 1.5/100 red blood cells versus 1.4 ± 2.8/100 red blood cells; P = 0.007), less frequent severe disease (4.4% versus 15.2%; P = 0.0005), accelerated parasite clearance and defervescence, and higher levels of antibodies to P. falciparum. These results suggest the persistence of acquired immunity to P. falciparum malaria after several years of non-exposure in African immigrants.
Received July 30, 2003. Accepted for publication August 2, 2004.
Financial support: This work was supported by the Institut de Médecine et d’Epidémiologie Africaine (Paris, France).
Authors’ addresses: Olivier Bouchaud, Sabine Kony, Rémy Durand, Ricarda Schiemann, Pascal Ralaimazava, Jean-Pierre Coulaud, and Jacques Le Bras, Institut de Médecine et d’Epidémiologie Africaine, 16 Rue Henri Huchard, 75018 Paris, France, Telephone: 33-1-44-85-63-00, Fax: 33-1-44-85-63-04, E-mail: imea{at}bichat.inserm.fr. Michel Cot and Philippe Deloron, Institut de Recherche pour le Développement, Unité de Recherche 010, Mother and Child Health in the Tropics, Faculté de Pharmacie, 4 Avenue de l’Observatoire, 75005 Paris, France, Telephone: 33-1-53-73-96-22, Fax: 33-1-53-73-96-17, E-mail: philippe.deloron{at}ird.fr.
Reprint requests: Olivier Bouchaud, Service des Maladies Infectieuses et Tropicales, Hôpital Avicenne, 125 Rue de Stalingrad, 93009 Bobigny, France, Telephone: 33-1-48-95-54-21, Fax: 33-1-48-95-54-28, E-mail: olivier.bouchaud{at}avc.ap-hop-paris.fr.
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