Top

Published in:

Open Access 01-12-2008 | Research

Pattern of humoral immune response to Plasmodium falciparum blood stages in individuals presenting different clinical expressions of malaria

Authors: Fabiana MS Leoratti, Rui R Durlacher, Marcus VG Lacerda, Maria G Alecrim, Antonio W Ferreira, Maria CA Sanchez, Sandra L Moraes

Published in: Malaria Journal | Issue 1/2008

Abstract

Background

The development of protective immunity against malaria is slow and to be maintained, it requires exposure to multiple antigenic variants of malaria parasites and age-associated maturation of the immune system. Evidence that the protective immunity is associated with different classes and subclasses of antibodies reveals the importance of considering the quality of the response. In this study, we have evaluated the humoral immune response against Plasmodium falciparum blood stages of individuals naturally exposed to malaria who live in endemic areas of Brazil in order to assess the prevalence of different specific isotypes and their association with different malaria clinical expressions.

Methods

Different isotypes against P. falciparum blood stages, IgG, IgG1, IgG2, IgG3, IgG4, IgM, IgE and IgA, were determined by ELISA. The results were based on the analysis of different clinical expressions of malaria (complicated, uncomplicated and asymptomatic) and factors related to prior malaria exposure such as age and the number of previous clinical malaria attacks. The occurrence of the H131 polymorphism of the FcγIIA receptor was also investigated in part of the studied population.

Results

The highest levels of IgG, IgG1, IgG2 and IgG3 antibodies were observed in individuals with asymptomatic and uncomplicated malaria, while highest levels of IgG4, IgE and IgM antibodies were predominant among individuals with complicated malaria. Individuals reporting more than five previous clinical malaria attacks presented a predominance of IgG1, IgG2 and IgG3 antibodies, while IgM, IgA and IgE antibodies predominated among individuals reporting five or less previous clinical malaria attacks. Among individuals with uncomplicated and asymptomatic malaria, there was a predominance of high-avidity IgG, IgG1, IgG2 antibodies and low-avidity IgG3 antibodies. The H131 polymorphism was found in 44.4% of the individuals, and the highest IgG2 levels were observed among asymptomatic individuals with this allele, suggesting the protective role of IgG2 in this population.

Conclusion

Together, the results suggest a differential regulation in the anti-P. falciparum antibody pattern in different clinical expressions of malaria and showed that even in unstable transmission areas, protective immunity against malaria can be observed, when the appropriated antibodies are produced.

Greenwood B: What can the residents of malaria endemic countries do to protect themselves against malaria?. Parassitologia. 1999, 41: 295-299.

Bouharoun-Tayoun H, Oeuvray C, Lunel F, Druilhe P: Mechanisms underlying the monocyte-mediated antibody killing of Plasmodium falciparum asexual blood stages. J Exp Med. 1995, 182: 409-418. 10.1084/jem.182.2.409.CrossRefPubMed

Plebanski M, Hill AVS: The immunology of malaria. Curr Opin Immunol. 2000, 12: 437-441. 10.1016/S0952-7915(00)00117-5.CrossRefPubMed

Bouharoun-Tayoun H, Attanath P, Sabchareon A, Chongsuphajaisiddhi T, Druilhe P: Antibodies that protect humans against Plasmodium falciparum blood stages do not on their own inhibit parasite growth and invasion in vitro, but act in cooperation with monocytes. J Exp Med. 1990, 172: 1633-1641. 10.1084/jem.172.6.1633.CrossRefPubMed

Groux H, Gysin J: Opsonization as an effector mechanism in human protection against asexual blood stages of Plasmodium falciparum: Functional role of IgG subclasses. Res Immunol. 1990, 141: 529-542. 10.1016/0923-2494(90)90021-P.CrossRefPubMed

Bouharoun-Tayoun H, Druilhe P: Plasmodium falciparum malaria: Evidence for an isotype imbalance which may be responsible for delayed acquisition of protective immunity. Infect Immun. 1992, 60: 1473-1481.PubMedCentral

Garraud O, Mahanty S, Perraut R: Malaria-specific antibody subclasses in immune individuals: a key source of information for vaccine design. Trends Immunol. 2003, 24: 30-35. 10.1016/S1471-4906(02)00012-1.CrossRefPubMed

Garraud O, Perraut R, Riveau G, Nutman : Class and subclass selection in parasite-specific antibody responses. Trends Parasitol. 2003, 19 (7): 300-304. 10.1016/S1471-4922(03)00139-9.CrossRefPubMed

Aribot G, Rogier C, Sarthou JL, Trape JF, Balde AT, Druilhe P, Roussilhon C: Pattern of immunoglobulin isotype response to Plasmodium falciparum blood-stage antigens in individuals living in a holoendemic area of Senegal (Dielmo, West Africa). Am J Trop Med Hyg. 1996, 54: 449-457.PubMed

10.

Shi YP, Sayed U, Qari SH, Robersts JM, Udhayakumar V, Oloo AJ, Hawley WA, Kaslow DC, Nahlen BL, Lal AA: Natural immune response to the C-terminal 19-kilodalton domain of Plasmodium falciparum merozoite surface protein 1. Infect Immun. 1996, 64: 2716-2723.PubMedCentralPubMed

11.

Tangteerawatana P, Krudsood S, Chalermrut K, Looareesuwan S, Khusmith S: Natural human IgG subclass antibodies to Plasmodium falciparum blood stage antigens and their relation to malaria resistance in an endemic area of Thailand Southeast. South-East Asian J Trop Med Public Health. 2001, 32: 247-254.

12.

Sarthou JL, Angel G, Aribot G, Rogier C, Dieye A, Balde AT, Diatta B, Seignot P, Roussilhon C: Prognostic value of anti-Plasmodium falciparum specific immunoglobulin G3, cytokines, and their soluble receptors in West Africa patients with severe malaria. Infect Immun. 1997, 65: 3271-3276.PubMedCentralPubMed

13.

Warmerdam PA, Winkel Van de JG, Vlug A, Westerdaal NA, Capel PJ: A single amino acid in the second Ig-like domain of the human Fcγ receptor II is critical for human IgG2 binding. J Immunol. 1991, 147: 1338-1343.PubMed

14.

Aucan C, Traoré Y, Tall F, Nacro B, Traoré-Leroux T, Fumoux F, Rihet P: High immunoglobulin G2 (IgG2) and low G4 (IgG4) levels are associated with human resistance to Plasmodium falciparum malaria. Infect Immun. 2000, 68: 1252-1258. 10.1128/IAI.68.3.1252-1258.2000.PubMedCentralCrossRefPubMed

15.

Troye-Blomberg M, Perlmann P, Nilsson M, Perlmann H: Immune regulation of protection and pathogenesis in Plasmodium falciparum malaria. Parassitologia. 1999, 41: 131-138.PubMed

16.

Desowitz RS: Plasmodium falciparum immunoglobulin E in sera from an area of holoendemic malaria. Trans R Soc Trop Med Hyg. 1989, 83: 478-479. 10.1016/0035-9203(89)90254-X.CrossRef

17.

Perlmann H, Helmby H, Hagstedt M, Carlson J, Larsson PH, Troye-Blomberg M, Perlmann P: IgE elevation and IgE anti-malarial antibodies in Plasmodium falciparum malaria: Association of high IgE levels with cerebral malaria. Clin Exp Immunol. 1994, 97: 284-292.PubMedCentralCrossRefPubMed

18.

Desowitz RS, Elm J, Alpers MP: Plasmodium falciparum – Specific immunoglobulin G (IgG), IgM and IgE antibodies in paired maternal-cord sera from East Sepik Province, Papua New Guinea. Infect Immun. 1993, 61: 988-993.PubMedCentralPubMed

19.

Maeno Y, Steketee R, Nagatake T, Tegoshi T, Desowitz RS, Wirima JJ, Aikawa M: Immunoglobulin complex deposits in Plasmodium falciparum-infected placentas from Malawi and Papua New Guinea. Am J Trop Med Hyg. 1993, 49: 574-580.PubMed

20.

Maeno Y, Perlmann P, Perlmann H, Kusuhara Y, Taniguchi K, Nakabayashi T, Win K, Looarreesuwan S, Aikawa M: IgE Deposition in brain microvessels and on parasited erythrocytes from cerebral malaria patients. Am J Trop Med Hyg. 2000, 63: 128-132.

21.

Luty AJF, Mayombo J, Lekoulou F, Mshana R: Immunologic Responses to Soluble Exoantigens of Plasmodium falciparum in Gabonese Children Exposed to Continuous Intense Infection. Am J Trop Med Hyg. 1994, 51: 720-729.PubMed

22.

Duarte J, Deshpande P, Guiyedi V, Mécheri S, Fesel C, Cazenave P-A, Mishra GC, Kombila M, Pied S: Total and functional parasite specific IgE responses in Plasmodium falciparum-infected patients exhibiting different clinical status. Malar J. 2007, 6: 1-13. 10.1186/1475-2875-6-1.PubMedCentralCrossRefPubMed

23.

Branch OH, Udhayakumar V, Hightower AW, Oloo AJ, Hawley WA, Nahlen BL, Bloland PB, Kaslow DC, Lal AA: A longitudinal investigation of IgG and IgM antibody response to the merozoite surface protein-1 19-kilodalton domain of Plasmodium falciparum in pregnant women and infants: associations with febrile illness parasitaemia and anemia. Am J Trop Med Hyg. 1998, 58: 211-219.PubMed

24.

Jayawardena AN, Janeway CA, Kemp JD: Experimental malaria in the CBA/N mouse. J Immunol. 1979, 123: 2532-2539.PubMed

25.

Harte PG, Cooke A, Playfair JH: Specific monoclonal IgM is a potent adjuvant in murine malaria vaccination. Nature. 1982, 302: 256-258. 10.1038/302256a0.CrossRef

26.

Boudin C, Chumptazi B, Dziegel M, Peyron F, Picot S, Hogh B, Ambroise-Thomas P: Possible role of specific immunoglobulin M antibodies to Plasmodium falciparum antigens in immunoprotection of human living in a hyperendemic area, Burkina Faso. J Clin Microbiol. 1993, 31: 636-641.PubMedCentralPubMed

27.

Avila SLM, Leandro MC, Carvalho NB, Oliveira MS, Arruk VG, Sanchez MCA, Boulos M, Ferreira AW: Evaluation of different methods for Plasmodia detection, in well defined population groups in an endemic area of Brazil. Rev Inst Med Trop Sao Paulo. 1994, 36 (2): 157-162.CrossRefPubMed

28.

Plikaytis BD, Holder PF, Pais LB, Maslanka SE, Gheesling LL, Carlone GM: Determination of parallelism and nonparallelism in bioassay dilution curves. J Clin Microbiol. 1994, 32: 2441-2447.PubMedCentral

29.

Jiang XM, Arepally G, Poncz M, Mckenzie S: Rapid detection of the FcγRIIA-H/R131 ligand- binding polymorphism using an allele- specific restriction enzyme digestion (ASRED). J Immunol Methods. 1996, 199: 55-59. 10.1016/S0022-1759(96)00164-0.CrossRefPubMed

30.

Snounou G, Viriyakosol S, Jarra W, Thaithong S, Brown KN: Identification of the four human malaria parasite species in field samples by the polymerase chain reaction and detection of a high prevalence of mixed infections. Mol Biochem Parasitol. 1993, 58: 283-292. 10.1016/0166-6851(93)90050-8.CrossRefPubMed

31.

Ferreira MU, Liu Q, Zhou M, Kimura M, Kaneko O, Thien HV, Isomura S, Tanabe K, Kawamoto F: Stable patterns of allelic diversity at the merozoite surface protein-1 locus of Plasmodium falciparum in clinical isolates from Southern Vietnam. J Eukaryot Microbiol. 1998, 45: 131-136. 10.1111/j.1550-7408.1998.tb05080.x.CrossRefPubMed

32.

Dubois B, Deleron P, Astagneau P, Chougnet C, Lepers JP: Isotypic analysis of Plasmodium falciparum-specific antibodies and their relation to protection in Madagascar. Infect Immun. 1993, 61: 4498-4500.PubMedCentralPubMed

33.

Rzepczyk CM, Hale K, Woodroffe N, Bobogare A, Csurhers P, Ishii A, Ferrante A: Humoral immune responses of Solomon Islanders to the merozoite surface antigen 2 of Plasmodium falciparum show pronounced skewing towards antibodies of the immunoglobulin G3 subclass. Infect Immun. 1997, 65: 1098-1100.PubMedCentralPubMed

34.

Taylor RR, Allen SJ, Grenwood BM, Riley EM: IgG3 antibodies to Plasmodium falciparum merozoite surface protein 2 (MSP2): increasing prevalence with age and association with clinical immunity to malaria. Am J Trop Med Hyg. 1998, 58: 406-413.PubMed

35.

Tangteerawatana P, Montgomery SM, Perlmann H, Looareesuwan S, Troye-Blomberg M, Khusmith S: Differential regulation of IgG subclasses and IgE antimalarial antibody responses in complicated and uncomplicated Plasmodium falciparum malaria. Parasite Immunol. 2007, 29: 475-483. 10.1111/j.1365-3024.2007.00965.x.CrossRefPubMed

36.

Lucchi NW, Tongren JE, Jain V, Nagpal AC, Kauth CW, Woehlbier U, Bujard H, Dash AP, Singh N, Stiles JK, Udhayakumar V: Antibody responses to the merozoite surface protein-1 complex in cerebral malaria patients in India. Malar J. 2008, 7: 121-134. 10.1186/1475-2875-7-121.PubMedCentralCrossRefPubMed

37.

A-Elgadir TME, Elbashir MI, Berzins K, Masuadi EM, A-Elbasit IE, ElGhazali G, Giha HA: The profile of IgG-antibody response against merozoite surface proteins 1 and 2 in severe Plasmodium falciparum malaria in Eastern Sudan. Parasitol Res. 2008, 102: 401-409. 10.1007/s00436-007-0777-3.CrossRefPubMed

38.

Nebie I, Diarra A, Ouedraogo A, Soulama I, Bougouma EC, Tiono AB, Konate AT, Chilengi R, Theisen M, Dodoo D, Remarque E, Bosomprah S, Milligan P, Sirima SB: Humoral responses to Plasmodium falciparum blood-stage antigens and association with incidence of clinical malaria in children living in an area of seasonal malaria transmission in Burkina Faso, West Africa. Infect Immun. 2008, 76: 759-766. 10.1128/IAI.01147-07.PubMedCentralCrossRefPubMed

39.

de Andrade AL, Martelli CM, Oliveira RM, Arias JR, Zicker F, Pang L: High prevalence of asymptomatic malaria in gold mining areas in Brazil. Clin Infect Dis. 1995, 20: 475-CrossRef

40.

Alves FP, Durlacher RR, Menezes MJ, Krieger H, da Silva LHP, Camargo EP: High prevalence of asymptomatic Plasmodium vivax and Plasmodium falciparum infections in native Amazonian populations. Am J Trop Med Hyg. 2002, 66: 641-648.PubMed

41.

Tebo AE, Kremsner PG, Luty AJ: Fc gamma receptor-mediated phagocytosis of Plasmodium falciparum-infected erythrocytes in vitro. Clin Exp Immunol. 2002, 130: 300-306. 10.1046/j.1365-2249.2002.01972.x.PubMedCentralCrossRefPubMed

42.

Omi K, Ohashi J, Patarapotikul J, Hananantachai H, Naka I, Looareesuwan S, Tokunaga K: Fc gamma receptor IIA and IIIB polymorphisms are associated with susceptibility to cerebral malaria. Parasitol Int. 2002, 51: 361-366. 10.1016/S1383-5769(02)00040-5.CrossRefPubMed

43.

Cooke GS, Aucan C, Walley AJ, Segal S, Greenwood BM, Kwiatkowski DC, Hill AVS: Association of Fcγ receptor IIA (CD32) polymorphism with severe malaria in West Africa. Am J Trop Med Hyg. 2003, 69: 565-568.PubMed

44.

Nasr A, Iriemenam NC, Troye-Blomberg M, Giha HA, Balogun HA, Osman OF, Montgomery SM, ElGhazali G, Berzins K: Fc gamma receptor IIa (CD32) polymorphism and antibody responses to asexual blood-stage antigens of Plasmodium falciparum malaria in Sudanese patients. Scand J Immunol. 2007, 66: 87-96. 10.1111/j.1365-3083.2007.01947.x.CrossRefPubMed

45.

Ouma C, Keller CC, Opondo DA, Were T, Otieno RO, Otieno MF, Orago ASS, Ong'echa JM, Vulule JM, Ferrell RE, Perkins DJ: Association of Fcγ receptor IIA (CD32) polymorphism with malarial anemia and high-density parasitemia in infants and young children. Am J Trop Med Hyg. 2006, 74: 573-577.PubMed

46.

Shi YP, Nahlen BL, Kariuki S, Urdahl KB, McElroy PD, Roberts JM, Lal AA: Fcγ receptor IIa (CD32) polymorphism is associated with protection of infants against high-density Plasmodium falciparum Infection. VII. Asembo Bay Cohort Project. J Infect Dis. 2001, 184: 107-111. 10.1086/320999.CrossRefPubMed

47.

Yee AMF, Phan HM, Zuniga R, Salmon JE, Musher DM: Association between FcgRIIa-R131 allotype and bacteremic pneumococcal pneumonia. Clin Infect Dis. 2000, 30: 25-28. 10.1086/313588.CrossRef

48.

Bredius RG, de Vries CE, Troelstra A, van Alphen L, Weening RS, Winkel van de JG, Out TA: Phagocytosis of Staphylococcus aureus and Haemophilus influenzae type B opsonized with polyclonal human IgG1 and IgG2 antibodies. Functional hFc gamma RIIa polymorphism to IgG2. J Immunol. 1993, 151: 1463-1472.PubMed

49.

Sanders LA, Winkel van de JG, Rijkers GT, Voorhorst-Ogink MM, de Haas M, Capel PJ, Zegers BJ: Fc gamma receptor IIa (CD32) heterogeneity in patients with recurrent bacterial respiratory tract infections. J Infect Dis. 1994, 170: 854-861.CrossRefPubMed

50.

Ferreira MU, Kimura EAS, Souza JM, Katzin AM: The isotype composition and avidity of naturally acquired anti-Plasmodium falciparum a ntibodies: differential patterns in clinically immune Africans and Amazonians patients. Am J Trop Med Hyg. 1996, 55: 315-323.PubMed

51.

Abbas AK, Lichtman AH, Pillai S: Cellular and Molecular Immunology. 2007, Philadelphia: Saunders Elsevier, 6

52.

Winkler S, Willheim M, Baier K, Schmid D, Aichelburg A, Graninger W, Kremsner PG: Reciprocal regulation of Th1- and Th2-cytokine-producing T cells during clearance of parasitemia in Plasmodium falciparum malaria. Infect Immun. 1998, 66: 6040-6044.PubMedCentralPubMed

53.

Garraud O, Perraut R, Diouf A, Nambei WS, Tall A, Spiegel A, Longacre S, Kaslow DC, Jouin H, Mattei D, Engler GM, Nutman TB, Riley EM, Mercereau-Puijalon O: Regulation of antigen-specific immunoglobulin G subclasses in response to conserved and polymorphic Plasmodium falciparum antigens in an in vitro model. Infect Immun. 2002, 70: 2820-2827. 10.1128/IAI.70.6.2820-2827.2002.PubMedCentralCrossRefPubMed

54.

Calissano C, Modiano D, Sirima BS, Konate A, Sanou I, Sawadogo A, Perlmann H, Troye-Blomberg M, Perlmann P: IgE antibodies to Plasmodium falciparum and severity of malaria in children of one ethnic group living in Burkina Faso. Am J Trop Med Hyg. 2003, 69: 31-35.PubMed

55.

Bereczky S, Montgomery SM, Troye-Blomberg M, Rooth I, Shaw MA, Farnert A: Elevated anti-malarial IgE in asymptomatic individuals is associated with reduced risk for subsequent clinical malaria. Int J Parasitol. 2004, 34: 935-942. 10.1016/j.ijpara.2004.04.007.CrossRefPubMed

56.

Farouk SE, Dolo A, Bereczky S, Kouriba B, Maiga B, Farnert A, Perlmann H, Hayano M, Montgomery SM, Doumbo OK, Troye-Blomberg M: Different antibody- and cytokine-mediated responses to P. falciparum parasite in two sympatric ethnic tribes living in Mali. Microbes Infect. 2005, 7: 110-117. 10.1016/j.micinf.2004.09.012.CrossRefPubMed

57.

Perlmann P, Perlmann H, Flyg BW, Hagstedt M, Elghazali G, Worku S, Fernandez V, Rutta AS, Troye-Blomberg M: Immunoglobulin E, a pathogenic factor in P. falciparum malaria. Infect Immun. 1997, 65: 116-121.PubMedCentralPubMed

58.

Perlmann P, Perlmann H, Looareesuwan S, Krudsood S, Kano S, Matsumoto Y, Brittenham G, Troye-Blomberg M, Aikawa M: Contrasting functions of IgG and IgE antimalarial antibodies in uncomplicated and severe P. falciparum malaria. Am J Trop Med Hyg. 2000, 62: 373-377.PubMed

59.

Seka-Seka J, Brouh Y, Yapo-Crezoit AC, Atseye NH: The role of serum immunoglobulin E in the pathogenesis of P. falciparum malaria in Ivorian children. Scand J Immunol. 2004, 59: 228-230. 10.1111/j.0300-9475.2004.01337.x.CrossRefPubMed

60.

Elghazali G, Perlmann H, Rutta AS, Perlmann P, Troye-Blomberg M: Elevated plasma levels of IgE in Plasmodium falciparum-primed individuals reflect an increased ratio of IL-4 to interferon-gamma (IFN-gamma)-producing cells. Clin Exp Immunol. 1997, 109: 84-89. 10.1046/j.1365-2249.1997.4401337.x.PubMedCentralCrossRefPubMed

61.

Perlmann P, Perlmann H, ElGhazali G, Blomberg MT: IgE and tumor necrosis factor in malaria infection. Immunol Lett. 1999, 65: 29-33. 10.1016/S0165-2478(98)00120-5.CrossRefPubMed

62.

Grau GE, Piguet P-F, Vassali P, Lambert P-H: Tumor-necrosis factor and disease severity in children with Plasmodium falciparum. N Engl J Med. 1989, 320: 1586-1591.CrossRefPubMed

63.

Kwiatkowski D, Hill AV, Sambou I, Twumasi P, Castracane J, Manogue KR, Cerami A, Brewster DR, Greenwood BM: TNF concentration in fatal cerebral, non-fatal cerebral, and uncomplicated Plasmodium falciparum malaria. Lancet. 1990, 336: 1201-1204. 10.1016/0140-6736(90)92827-5.CrossRefPubMed

64.

Thakar YS, Chande C, Dhanvijay AG, Pande S, Saoji AM: Analysis of immunoglobulin deficiency cases: a five year study. Indian J Pathol Microbiol. 1997, 40: 309-13.

65.

Manis JP, Tian M, Alt FW: Mechanism and control of class-switch recombination. Trends Immunol. 2002, 23: 31-39. 10.1016/S1471-4906(01)02111-1.CrossRefPubMed

66.

Osier FHA, Fegan G, Polley SD, Murungi L, Verra F, Tetteh KKA, Lowe B, Mwangi T, Bull PC, Thomas AW, Cavanagh DR, McBride JS, Lanar DE, Mackinnon MJ, Conway DJ, Marsh K: Breadth and magnitude of antibody responses to multiple Plasmodium falciparum merozoite antigens are associated with protection from clinical malaria. Infect Immun. 2008, 76: 2240-2248. 10.1128/IAI.01585-07.PubMedCentralCrossRefPubMed

Title: Pattern of humoral immune response to Plasmodium falciparum blood stages in individuals presenting different clinical expressions of malaria
Authors: Fabiana MS Leoratti
Rui R Durlacher
Marcus VG Lacerda
Maria G Alecrim
Antonio W Ferreira
Maria CA Sanchez
Sandra L Moraes
Publication date: 01-12-2008
Publisher: BioMed Central
Published in: Malaria Journal / Issue 1/2008
Electronic ISSN: 1475-2875
DOI: https://doi.org/10.1186/1475-2875-7-186

ACC 2024 Congress Coverage

Heart Failure Video

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Pattern of humoral immune response to Plasmodium falciparum blood stages in individuals presenting different clinical expressions of malaria

Abstract

Background

Methods

Results

Conclusion

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2008

Evaluation of an operational malaria outbreak identification and response system in Mpumalanga Province, South Africa

Host choice and multiple blood feeding behaviour of malaria vectors and other anophelines in Mwea rice scheme, Kenya

The usefulness of a new rapid diagnostic test, the First Response® Malaria Combo (pLDH/HRP2) card test, for malaria diagnosis in the forested belt of central India

Consanguineous marriages and endemic malaria: can inbreeding increase population fitness?

Individual, facility and policy level influences on national coverage estimates for intermittent preventive treatment of malaria in pregnancy in Tanzania

The resting sites and blood-meal sources of Anopheles minimus in Taiwan

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page