TY - JOUR T1 - Determination of the Processes Driving the Acquisition of Immunity to Malaria Using a Mathematical Transmission Model A1 - Filipe, João A. N A1 - Riley, Eleanor M A1 - Drakeley, Christopher J A1 - Sutherland, Colin J A1 - Ghani, Azra C Y1 - 2007/12/28 N2 - Author SummaryWhilst it is clear that natural immunity to malaria infection develops in those living in malaria-endemic regions of the world, the precise way in which it is acquired and the duration of immune memory are less-well-understood. We used a mathematical model that mimics malaria transmission between humans and mosquitoes in endemic settings to explore what epidemiological data, and in particular the prevalence of malaria in different aged individuals, can tell us about how immunity might develop. We explored three different parts of the transmission cycle at which immunity could act: 1) reducing the likelihood that an infected person develops symptomatic disease; 2) increasing the rate at which infection is cleared, and 3) increasing the duration of low-level (subpatent) infections that would continue to boost the immune system and hence protect against further disease. Our results show that the first two mechanisms together give rise to patterns of malaria by age group that are consistent with those observed in different malaria endemic settings in Africa. Our model also suggests that immunity to symptomatic disease lasts for at least five years, develops faster if there are higher levels of infection in the population, and increases with age. On the other hand, our model suggests that immunity that helps to clear infection lasts longer (20 years or more), develops later in life, and does not depend on the amount of transmission in the population. JF - PLOS Computational Biology JA - PLOS Computational Biology VL - 3 IS - 12 UR - https://doi.org/10.1371/journal.pcbi.0030255 SP - e255 EP - PB - Public Library of Science M3 - doi:10.1371/journal.pcbi.0030255 ER -