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HIGH TITERS OF IgG ANTIBODIES AGAINST PLASMODIUM FALCIPARUM SERINE REPEAT ANTIGEN 5 (SERA5) ARE ASSOCIATED WITH PROTECTION AGAINST SEVERE MALARIA IN UGANDAN CHILDREN

Plasmodium falciparum serine repeat antigen (SERA5) is a promising asexual blood stage malaria candidate vaccine. However, there is a paucity of information about natural immune responses to SERA5 in children from malaria-endemic regions. We undertook a hospital-based case-control study of severe malaria in Apac District, Northern Uganda, in children 6–59 months of age. The commonest symptoms observed in children with severe malaria (SM) were respiratory distress (53.4%) and prostration (40.4%) followed by circulatory collapse (7.4%), severe anemia (Hb < 5 g/dL, 7.0%), and seizures (2.6%). None of the SM children had impaired consciousness, coma, or cerebral malaria. We measured serum IgG antibodies using a recombinant construct of SERA5 (SE36) in enzyme-linked immunosorbent assays. High titers of IgG anti-SE36 were associated with protection against severe malaria in children under 5 years old.

Received February 10, 2005. Accepted for publication April 14, 2005.

Acknowledgments: We are grateful to the mothers and children of Apac District as well as the staff at Apac Hospital who made this study possible and to Halima Nanyonjo for assisting in data entry.

Financial support: Thomas G. Egwang is an International Research Scholar of the Howard Hughes Medical Institute. These studies were also supported by the UNDP/World Bank WHO Special Program for Research and Training in Tropical Diseases (TDR Project 990368).

^* Address correspondence to Thomas G. Egwang, Med Biotech Laboratories, P.O. Box 9364, Kampala, Uganda. E-mail: tgegwang{at}mblab.org

Authors’ addresses: Brenda Okech, Med Biotech Laboratories, P.O. Box 9364, Kampala, Uganda, Telephone: +256 41 510246, Fax: +256 41 510408. Godfrey Mujuzi, Med Biotech Laboratories, P.O. Box 9364, Kampala, Uganda, Telephone: +256 41 510246, Fax: +256 41 510408. Alex Ogwal, Med Biotech Laboratories, P.O. Box 9364, Kampala, Uganda, Telephone: +256 41 510246, Fax: +256 41 510408. Hiroki Shirai, Kan-on-ji Institute, The Research Foundation for Microbial Diseases of Osaka University, 2-9-41, Yahata-cho, Kannonji, Kagawa, 768-0061 Japan. Toshiro Horii, Department of Molecular Protozoology, Research Institute for Microbial Diseases, Osaka University, Suita Osaka 565-0871, Japan, Telephone: +81-6-68798280, Fax: +81-6-68798281. Thomas G. Egwang, Med Biotech Laboratories, P.O. Box 9364, Kampala, Uganda, Telephone: +256 41 510245, Fax: +256 41 510408, E-mail: tgegwang{at}mblab.org.

Reprint requests: Thomas G. Egwang, Med Biotech Laboratories, P.O. Box 9364, Kampala, Uganda, Telephone: +256 41 510245, Fax: +256 41 510408, E-mail: tgegwang{at}mblab.org.

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