A model of parity-dependent immunity to placental malaria

Walker, Patrick G. T.; Griffin, Jamie T.; Cairns, Matt; Rogerson, Stephen J.; van Eijk, Anna M.; ter Kuile, Feiko; Ghani, Azra C.

doi:10.1038/ncomms2605

Cited by 57Malaria Research and ControlMathematical and Theoretical Epidemiology and Ecology ModelsReproductive System and Pregnancy

A model of parity-dependent immunity to placental malaria

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Walker, Patrick G. T., Griffin, Jamie T., Cairns, Matt, Rogerson, Stephen J., van Eijk, Anna M., ter Kuile, Feiko, Ghani, Azra C.·2013·Nature Communications

DOI 10.1038/ncomms2605PMC PMC3615483

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Abstract

Plasmodium falciparum placental infection during pregnancy is harmful for both mother and child. Protection from placental infection is parity-dependent, that is, acquired over consecutive pregnancies. However, the infection status of the placenta can only be assessed at delivery. Here, to better understand the mechanism underlying this parity-dependence, we fitted a model linking malaria dynamics within the general population to observed placental histology. Our results suggest that immunity resulting in less prolonged infection is a greater determinant of the parity-specific patterns than immunity that prevents placental sequestration. Our results also suggest the time when maternal blood first flows into the placenta is a high-risk period. Therefore, preventative strategies implementable before or early in pregnancy, such as insecticide-treated net usage in women of child-bearing age or any future vaccine, could substantially reduce the number of women who experience placental infection. Exposure to malaria during pregnancy can result in its spread to the placenta; however, the risk of placental infection decreases with subsequent pregnancies. By constructing a mathematical model, the authors find that this is likely due to a reduction in the duration of infection rather than a reduced risk of transfer.

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In areas of high P. falciparum transmission, pregnant women develop partial immunity to placental infection through repeated malaria exposure over successive pregnancies.
“In areas of high P. falciparum transmission, pregnant women develop partial immunity to placental infection through repeated malaria exposure over successive pregnancies [7–10].”
From Global estimates of pregnancies at risk of Plasmodium falciparum and Plasmodium vivax infection in 2020 and changes in risk patterns since 2000 (2022) · cites this paper as [9]
An estimated 70% of infections among primigravidae are acquired before pregnancy.
“an estimated 70% of infections among primigravidae are acquired before pregnancy [9].”
From Global estimates of pregnancies at risk of Plasmodium falciparum and Plasmodium vivax infection in 2020 and changes in risk patterns since 2000 (2022) · cites this paper as [9]

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Additional file 2 of Gravidity and malaria trends interact to modify P. falciparum densities and detectability in pregnancy: a 3-year prospective multi-site observational study
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Additional file 4 of Gravidity and malaria trends interact to modify P. falciparum densities and detectability in pregnancy: a 3-year prospective multi-site observational study
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Additional file 3 of Gravidity and malaria trends interact to modify P. falciparum densities and detectability in pregnancy: a 3-year prospective multi-site observational study
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Additional file 1 of Gravidity and malaria trends interact to modify P. falciparum densities and detectability in pregnancy: a 3-year prospective multi-site observational study
Matambisso, G., Brokhattingen, N., Maculuve, S., Cisteró, P., Mbeve, H., Escoda, A., Miguel, J., Buetas, E., de Jong, I., Cuna, B., et al. (2022) · Figshare · doi:10.6084/m9.figshare.21557582
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Plasmodiumin the placenta: parasites, parity, protection, prevention and possibly preeclampsia
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Authors: Walker, P. G. T., Griffin, J. T., Cairns, M., Rogerson, S. J., van Eijk, A. M., ter Kuile, F., & Ghani, A. C.
Affiliations: Imperial College London (GB)
The Royal Melbourne Hospital (AU)
Corresponding author: Walker, Patrick G. T.
ORCID: Walker, Patrick G. T.
Rogerson, Stephen J.
Ghani, Azra C.
Venue: Nature Communications
Publisher: Springer Science and Business Media LLC
Published: 2013-03-19
Volume: 4
Issue: 1
Pages: 1609-1609
ISSN: 2041-1723 (ISSN-L)
DOI: 10.1038/ncomms2605
PMC: PMC3615483
OpenAlex: W2008016258
Cited by: 57
References: 45
Citations by year: 2026: 3 · 2025: 3 · 2024: 2 · 2023: 1 · 2022: 11 · 2020: 6 · 2019: 2 · 2018: 11 · 2017: 7 · 2016: 2 · 2015: 6 · 2014: 3
FWCI: 3.74
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by-nc-sa
creativecommons.org/licenses/by-nc-sa/3.0 (unspecified)
Locations: Nature Communications (publishedVersion, cc-by-nc-sa)
Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-sa)
PubMed Central (publishedVersion, cc-by-nc-sa)
PubMed (publishedVersion)
LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
Minerva Access (University of Melbourne) (submittedVersion, cc-by-nc-sa)
RePEc: Research Papers in Economics (submittedVersion)
LSTM Online Archive (Liverpool School of Tropical Medicine) (submittedVersion)
Minerva Access (University of Melbourne) (submittedVersion)
Spiral (Imperial College London) (submittedVersion, cc-by-nc-sa)
Funders: Bill and Melinda Gates Foundation
Medical Research Council (MR/K010174/1, MR/J012394/1, MR/K012126/1, EU FP7)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Mathematical and Theoretical Epidemiology and Ecology Models
Life Sciences › Immunology and Microbiology › Immunology › Reproductive System and Pregnancy
Keywords: placental malaria, Plasmodium falciparum, pregnancy, maternal immunity, placental sequestration, placental histology, mathematical model, malaria vaccine, insecticide-treated nets, malaria in pregnancy
MeSH terms: Female, Humans, Placenta Diseases, Pregnancy, Pregnancy Complications, Parasitic, Malaria, Falciparum

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A model of parity-dependent immunity to placental malaria

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