Low-level Plasmodium vivax exposure, maternal antibodies, and anemia in early childhood: Population-based birth cohort study in Amazonian Brazil.

<h4>Background</h4>Malaria causes significant morbidity and mortality in children under 5 years of age in sub-Saharan Africa and the Asia-Pacific region. Neonates and young infants remain relatively protected from clinical disease and the transplacental transfer of maternal antibodies is...

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Autores principales:	Anaclara Pincelli, Marly A Cardoso, Maíra B Malta, Igor C Johansen, Rodrigo M Corder, Vanessa C Nicolete, Irene S Soares, Marcia C Castro, Marcelo U Ferreira, MINA-Brazil Study Working Group
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/d2ee5715a2204115afabcc3c41974865
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spelling	oai:doaj.org-article:d2ee5715a2204115afabcc3c419748652021-12-02T20:23:45ZLow-level Plasmodium vivax exposure, maternal antibodies, and anemia in early childhood: Population-based birth cohort study in Amazonian Brazil.1935-27271935-273510.1371/journal.pntd.0009568https://doaj.org/article/d2ee5715a2204115afabcc3c419748652021-07-01T00:00:00Zhttps://doi.org/10.1371/journal.pntd.0009568https://doaj.org/toc/1935-2727https://doaj.org/toc/1935-2735<h4>Background</h4>Malaria causes significant morbidity and mortality in children under 5 years of age in sub-Saharan Africa and the Asia-Pacific region. Neonates and young infants remain relatively protected from clinical disease and the transplacental transfer of maternal antibodies is hypothesized as one of the protective factors. The adverse health effects of Plasmodium vivax malaria in early childhood-traditionally viewed as a benign infection-remain largely neglected in relatively low-endemicity settings across the Amazon.<h4>Methodology/principal findings</h4>Overall, 1,539 children participating in a birth cohort study in the main transmission hotspot of Amazonian Brazil had a questionnaire administered, and blood sampled at the two-year follow-up visit. Only 7.1% of them experienced malaria confirmed by microscopy during their first 2 years of life- 89.1% of the infections were caused by P. vivax. Young infants appear to be little exposed to, or largely protected from infection, but children >12 months of age become as vulnerable to vivax malaria as their mothers. Few (1.4%) children experienced ≥4 infections during the 2-year follow-up, accounting for 43.4% of the overall malaria burden among study participants. Antenatal malaria diagnosed by microscopy during pregnancy or by PCR at delivery emerged as a significant correlate of subsequent risk of P. vivax infection in the offspring (incidence rate ratio, 2.58; P = 0.002), after adjusting for local transmission intensity. Anti-P. vivax antibodies measured at delivery do not protect mothers from subsequent malaria; whether maternal antibodies transferred to the fetus reduce early malaria risk in children remains undetermined. Finally, recent and repeated vivax malaria episodes in early childhood are associated with increased risk of anemia at the age of 2 years in this relatively low-endemicity setting.<h4>Conclusions/significance</h4>Antenatal infection increases the risk of vivax malaria in the offspring and repeated childhood P. vivax infections are associated with anemia at the age of 2 years.Anaclara PincelliMarly A CardosoMaíra B MaltaIgor C JohansenRodrigo M CorderVanessa C NicoleteIrene S SoaresMarcia C CastroMarcelo U FerreiraMINA-Brazil Study Working GroupPublic Library of Science (PLoS)articleArctic medicine. Tropical medicineRC955-962Public aspects of medicineRA1-1270ENPLoS Neglected Tropical Diseases, Vol 15, Iss 7, p e0009568 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
spellingShingle	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Anaclara Pincelli Marly A Cardoso Maíra B Malta Igor C Johansen Rodrigo M Corder Vanessa C Nicolete Irene S Soares Marcia C Castro Marcelo U Ferreira MINA-Brazil Study Working Group Low-level Plasmodium vivax exposure, maternal antibodies, and anemia in early childhood: Population-based birth cohort study in Amazonian Brazil.
description	<h4>Background</h4>Malaria causes significant morbidity and mortality in children under 5 years of age in sub-Saharan Africa and the Asia-Pacific region. Neonates and young infants remain relatively protected from clinical disease and the transplacental transfer of maternal antibodies is hypothesized as one of the protective factors. The adverse health effects of Plasmodium vivax malaria in early childhood-traditionally viewed as a benign infection-remain largely neglected in relatively low-endemicity settings across the Amazon.<h4>Methodology/principal findings</h4>Overall, 1,539 children participating in a birth cohort study in the main transmission hotspot of Amazonian Brazil had a questionnaire administered, and blood sampled at the two-year follow-up visit. Only 7.1% of them experienced malaria confirmed by microscopy during their first 2 years of life- 89.1% of the infections were caused by P. vivax. Young infants appear to be little exposed to, or largely protected from infection, but children >12 months of age become as vulnerable to vivax malaria as their mothers. Few (1.4%) children experienced ≥4 infections during the 2-year follow-up, accounting for 43.4% of the overall malaria burden among study participants. Antenatal malaria diagnosed by microscopy during pregnancy or by PCR at delivery emerged as a significant correlate of subsequent risk of P. vivax infection in the offspring (incidence rate ratio, 2.58; P = 0.002), after adjusting for local transmission intensity. Anti-P. vivax antibodies measured at delivery do not protect mothers from subsequent malaria; whether maternal antibodies transferred to the fetus reduce early malaria risk in children remains undetermined. Finally, recent and repeated vivax malaria episodes in early childhood are associated with increased risk of anemia at the age of 2 years in this relatively low-endemicity setting.<h4>Conclusions/significance</h4>Antenatal infection increases the risk of vivax malaria in the offspring and repeated childhood P. vivax infections are associated with anemia at the age of 2 years.
format	article
author	Anaclara Pincelli Marly A Cardoso Maíra B Malta Igor C Johansen Rodrigo M Corder Vanessa C Nicolete Irene S Soares Marcia C Castro Marcelo U Ferreira MINA-Brazil Study Working Group
author_facet	Anaclara Pincelli Marly A Cardoso Maíra B Malta Igor C Johansen Rodrigo M Corder Vanessa C Nicolete Irene S Soares Marcia C Castro Marcelo U Ferreira MINA-Brazil Study Working Group
author_sort	Anaclara Pincelli
title	Low-level Plasmodium vivax exposure, maternal antibodies, and anemia in early childhood: Population-based birth cohort study in Amazonian Brazil.
title_short	Low-level Plasmodium vivax exposure, maternal antibodies, and anemia in early childhood: Population-based birth cohort study in Amazonian Brazil.
title_full	Low-level Plasmodium vivax exposure, maternal antibodies, and anemia in early childhood: Population-based birth cohort study in Amazonian Brazil.
title_fullStr	Low-level Plasmodium vivax exposure, maternal antibodies, and anemia in early childhood: Population-based birth cohort study in Amazonian Brazil.
title_full_unstemmed	Low-level Plasmodium vivax exposure, maternal antibodies, and anemia in early childhood: Population-based birth cohort study in Amazonian Brazil.
title_sort	low-level plasmodium vivax exposure, maternal antibodies, and anemia in early childhood: population-based birth cohort study in amazonian brazil.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/d2ee5715a2204115afabcc3c41974865
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Low-level Plasmodium vivax exposure, maternal antibodies, and anemia in early childhood: Population-based birth cohort study in Amazonian Brazil.

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