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ANTIBODY RESPONSES TO SEVERAL MALARIA PRE-ERYTHROCYTIC ANTIGENS AS A MARKER OF MALARIA EXPOSURE AMONG TRAVELERS

Protective devices against vectors are used by travelers in malaria-endemic areas but their efficacy for protection against mosquitoes has rarely been evaluated. The level of exposure to malaria transmission of 205 soldiers deployed in Africa and the efficacy of their anti-vector prophylaxis was evaluated by comparison of their IgM and IgG responses against five pre-erythrocytic Plasmodium falciparum antigens (circumsporozoite protein, sporozoite threonine- and asparagine-rich protein, sporozoite- and liver-stage antigen, liver stage antigen 1, and SR11.1) before and at the end of their deployment, and three months after returning to France for 106 of these soldiers. The immune responses increased significantly during the mission in 35% (95% confidence interval = 28–42%) of the individuals. The permanent use of insecticide-treated bed nets and long-sleeve battle dress at night were associated with protective efficacy. The analysis of these antibody responses was sensitive enough to evaluate exposure to malaria transmission and the efficacy of anti-vector devices in travelers using antimalarial chemoprophylaxis.

Received November 17, 2005. Accepted for publication January 18, 2006.

Acknowledgments: We thank all volunteers and the medical team of Régiment de Chasseur Parachutiste (Pamiers, France) for participating in the study. We also thank F. Remoue (Institut de Recherche et de Développement, Dakar, Senegal) and A. Buguet for critically reading the manuscript and C. Dane (Délégation Générale pour l’Armement, Paris, France) for support and advice.

Financial support: This study was supported by Délégation Générale pour l’Armement (grant 02CO011, no. 010808).

^* Address correspondence to Christophe Rogier, Unité de Recherche en Biologie et Épidémiologie Parasitaires, Institut de Médecine Tropicale du Service de Santé des Armées, Boulevard Charles Livon, Parc le Pharo, BP 46, 13998 Marseille Armées, France and Institut Fédératif de la Recherche 48, 13005 Marseille, France. E-mail: christophe.rogier{at}wanadoo.fr

Author’ addresses: Eve Orlandi-Pradines, Kristell Penhoat, Claude Durand, Bruno Pradines, Thierry Fusai, and Christophe Rogier, Unité de Recherche en Biologie et Épidémiologie Parasitaires, Institut de Médecine Tropicale du Service de Santé des Armées, Boulevard Charles Livon, Parc le Pharo, BP 46, 13998 Marseille Armées, France and Institut Fédératif de la Recherche 48, 13005 Marseille, France, Telephone: 33-4-91-15-01-50, Fax: 33-4-91-15-01-64. E-mails: sururu{at}caramail.com, bruno.pradines{at}free.fr, thierry.fusai{at}free.fr, and christophe.rogier{at}wanadoo.fr. Christophe Pons and Christian Bay, Service de Santé du Premier Régiment de Chasseurs Parachutistes, Quartier Capitaine Beaumont, 09105 Pamiers, France, Telephone: 33-5-34-01-99-99, Fax: 33-5-34-01-99-48. Richard Josse, Département d’Épidémiologie de l’Hôpital d’Instruction des Armées Robert Picqué, Bordeaux, France, Telephone: 33-5-56-84-70-42, Fax: 33-5-56-84-72-90. Philippe Dubrous, Laboratoire de Biologie Médicale de l’Hôpital d’Instruction des Armées Robert Picqué, Bordeaux, France, Telephone: 33-5-56-84-74-27, Fax: 33-5-56-84-72-90. Jean-Baptiste Meynard, Rene Migliani and Jean-Paul Boutin, Département d’Épidémiologie et de Santé Publique Sud, Institut de Médecine Tropicale du Service de Santé des Armées, Boulevard Charles Livon, Parc le Pharo, BP 46, 13998 Marseille Armées, France and Institut Fédératif de la Recherche 48, 13005 Marseille, France, Telephone: 33-4-91-15-25, Fax: 33-4-91-15-01-84, E-mail: imtssa.desp{at}wanadoo.fr. Jean-Paul Durand, Unité de Virologie, Institut de Médecine Tropicale du Service de Santé des Armées, Boulevard Charles Livon, Parc le Pharo, BP 46, 13998 Marseille Armées, France. Pierre Druilhe, Laboratoire de Parasitologie Bio-Médicale, Institut Pasteur, 28 Rue du Dr. Roux, 75015 Paris, France, Telephone: 33-1-45-68-85-78, Fax: 33-1-45-68-86-40, E-mail: druilhe{at}pasteur.fr.