Volume 76, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


In a treatment re-infection study of 206 Papua New Guinean school children, we examined risk of reinfection and symptomatic malaria caused by different species. Although children acquired a similar number of polymerase chain reaction–detectable and infections in six months of active follow-up ( = 5.00, = 5.28), they were 21 times more likely to develop symptomatic malaria (1.17/year) than malaria (0.06/year). Children greater than nine years of age had a reduced risk of acquiring infections of low-to-moderate (>150/μL) density (adjusted hazard rate [AHR] = 0.65 and 0.42), whereas similar reductions in risk with age of infection was only seen for parasitemias > 5,000/μL (AHR = 0.49) and symptomatic episodes (AHR = 0.51). Infection and symptomatic episodes with and were rare. By nine years of age, children have thus acquired almost complete clinical immunity to characterized by a very tight control of parasite density, whereas the acquisition of immunity to symptomatic malaria remained incomplete. These observations suggest that different mechanisms of immunity may be important for protection from these malaria species.


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  • Received : 03 Dec 2006
  • Accepted : 01 Feb 2007

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