FcγRIIa polymorphism and anti-malaria-specific IgG and IgG subclass responses in populations differing in susceptibility to malaria in Burkina Faso.

FcγRIIa is known to be polymorphic; and certain variants are associated with different susceptibilities to malaria. Studies involving the Fulani ethnic group reported an ethnic difference in FcγRIIa-R131H genotype frequencies between the Fulani and other sympatric groups. No previous studies have addressed these questions in Burkina Faso. This study aimed to assess the influence of FcγRIIa-R131H polymorphism on anti-falciparum malaria IgG and IgG subclass responses in the Fulani and the Mossi ethnic groups living in Burkina Faso. Healthy adults more than 20 years old belonging to the Mossi or the Fulani ethnic groups were enrolled for the assessment of selected parasitological, immunological and genetic variables in relation to their susceptibility to malaria. The prevalence of the Plasmodium falciparum infection frequency was relatively low in the Fulani ethnic group compared to the Mossi ethnic group. For all tested antigens, the Fulani had higher antibody levels than the Mossi group. In both ethnic groups, a similar distribution of FcγRIIa R131H polymorphism was found. Individuals with the R allele of FcγRIIa had higher antibody levels than those with the H allele. This study confirmed that malaria infection affected less the Fulani group than the Mossi group. FcγRIIa-R131H allele distribution is similar in both ethnic groups, and higher antibody levels are associated with the FcγRIIa R allele compared to the H allele.

Vaccine potentials of an intrinsically unstructured fragment derived from the blood stage-associated Plasmodium falciparum protein PFF0165c.

We have identified new malaria vaccine candidates through the combination of bioinformatics prediction of stable protein domains in the Plasmodium falciparum genome, chemical synthesis of polypeptides, in vitro biological functional assays, and association of an antigen-specific antibody response with protection against clinical malaria. Within the predicted open reading frame of P. falciparum hypothetical protein PFF0165c, several segments with low hydrophobic amino acid content, which are likely to be intrinsically unstructured, were identified. The synthetic peptide corresponding to one such segment (P27A) was well recognized by sera and peripheral blood mononuclear cells of adults living in different regions where malaria is endemic. High antibody titers were induced in different strains of mice and in rabbits immunized with the polypeptide formulated with different adjuvants. These antibodies recognized native epitopes in P. falciparum-infected erythrocytes, formed distinct bands in Western blots, and were inhibitory in an in vitro antibody-dependent cellular inhibition parasite-growth assay. The immunological properties of P27A, together with its low polymorphism and association with clinical protection from malaria in humans, warrant its further development as a malaria vaccine candidate.

Humoral and cell-mediated immunity to MSP3 peptides in adults immunized with MSP3 in malaria endemic area, Burkina Faso.

We performed a single-blind, randomized phase 1 trial of the long synthetic peptide (LSP) of merozoite surface protein-3 (MSP3) in adults living in Burkina Faso. Thirty eligible volunteers were randomized to receive either the MSP3-LSP candidate vaccine or tetanus toxoid vaccine as a control. A dose of each vaccine was administered on days 0, 28 and 112 and the vaccine was formulated with aluminium hydroxide. Humoral immune responses were assessed by ELISA at days 0, 28, 56, 112, 140, 252 and 365 and cell-mediated immune responses by lymphoproliferation assay and by ELISA on days 0, 56 and 140. IgG responses to four peptides of MSP3 were similar in both vaccine groups. Higher IgG concentrations were recorded after the beginning of malaria high transmission season in both vaccine groups. The lymphocyte proliferation and the production of IFN-gamma in response to stimulation with the four overlapping peptides increased following vaccination in the MSP3-LSP vaccine group, but did not change appreciably in the control group. In contrast to natural infection, MSP3-LSP did not boost humoral responses to the four overlapping peptides of MSP3 to any detectable degree in our semi-immune adult. MSP3-LSP may be more immunogenic in young children with little or no acquired immunity.

[Change of antimalarial first-line treatment in Burkina Faso in 2005]. / Les raisons d'un changement de médicaments de première intention pour le traitement du paludisme simple au Burkina Faso en 2005.

Burkina Faso has recently changed the antimalarial drug policy to artesunate/amodiaquine or artemether/lumefantrine as the first-line antimalarial drug and sulfadoxine/pyrimethamine for the intermittent preventive treatment in pregnant woman. Before the implementation of this new strategy we conducted an in vivo efficacy study with chloroquine or sulfadoxine/pyrimethamine for treatment of uncomplicated Plasmodium falciparum malaria in urban area of Burkina from September to December 2003. Chloroquine (25 mg/kg over 3 days) or sulfadoxine/pyrimethamine (25 mg/kg + 0.025 mg/kg single dose) was administered respectively to 137 and 125 children aged from 6 to 59 months old in a randomized, opened study. Follow up extended over 28 days using modified WHO protocol. After adjusting the results by PCR, treatment failures rates were 63.4% (83/131) and 13.8% (17/123) respectively for chloroquine and sulfadoxine/pyrimethamine. These results with other observations have justified the change of malaria therapy policy in Burkina Faso in 2005.

Do antibody responses to malaria vaccine candidates influenced by the level of malaria transmission protect from malaria?

OBJECTIVES: To examine whether the humoural response to malaria vaccine candidate antigens, Plasmodium falciparum [circumsporozoite repetitive sequence (NANP)(5) GLURP fragments (R0 and R2) and MSP3] varies with the level of malaria transmission and to determine whether the antibodies (IgG) present at the beginning of the malaria transmission season protect against clinical malaria. METHODS: Cross-sectional surveys were conducted to measure antibody response before, at the peak and at the end of the transmission season in children aged 6 months to 10 years in two villages with different levels of malaria transmission. A cohort study was performed to estimate the incidence of clinical malaria. RESULTS: Antibodies to these antigens showed different seasonal patterns. IgG concentrations to any of the four antigens were higher in the village with high entomological inoculation rate. Multivariate analysis of combined data from the two villages indicated that children who were classified as responders to the selected antigens were at lower risk of clinical malaria than children classified as non-responders [(NANP)(5) (incidence rate ratio (IRR) = 0.65, 95% CI: 0.46-0.92; P = 0.016), R0 (IRR = 0.69, 95% CI: 0.48-0.97; P = 0.032), R2 (IRR = 0.73, 95% CI: 0.50-1.06; P = 0.09), MSP3 (IRR = 0.52, 95% CI: 0.32-0.85; P = 0.009)]. Fitting a model with all four antibody responses showed that MSP3 looked the best malaria vaccine candidate (IRR = 0.63; 95% CI: 0.38-1.05; P = 0.08). CONCLUSION: Antibody levels to the four antigens are affected by the intensity of malaria transmission and associated with protection against clinical malaria. It is worthwhile investing in the development of these antigens as potential malaria vaccine candidates.

[Comparative impact of three malaria preventive regimens during pregnancy on maternal anemia due to malaria in Burkina Faso]. / Impact comparatif de trois schémas de prévention du paludisme pendant la grossesse sur l'anémie maternelle, associée à l'infection palustre au Burkina Faso.

OBJECTIVES: The main objective of this study was to compare the efficacy of three regimens of malaria prevention during pregnancy for the reduction of anemia between the first and third antenatal consultations. The first treatment arm was the classical weekly chemoprophylaxis with chloroquine; the other two were the intermittent preventive treatment using either three doses of chloroquine or sulfadoxine-pyrimethamine. DESIGN: We conducted an open, randomized, three-arm study in a rural district of Burkina Faso. A cohort was constituted by 648 pregnant women of any parity. RESULTS: The hemoglobin gain was more significant with the intermittent preventive treatment using sulfadoxine-pyrimethamine compared to the other treatment arms. The hemoglobin increased from 10.3g/dl (at the first antenatal consultation) to 11.4 g/dl (at the third antenatal consultation). In the three arms of treatment, the chemoprophylaxis reduced the prevalence of moderate anemia and severe anemia. The reduction of moderate anemia was more substantial in the sulfadoxine-pyrimethamine arm (65.6 to 36.7%) at second antenatal consultation (p=0.069) and third antenatal consultation (p=0.014). Conversely, in the two chloroquine arms, there was no significant reduction either at second antenatal consultation (p=0.72) or third antenatal consultation (p=0.55). The prevalence of peripheral parasitemia decreased in all treatment groups. However, it was significantly higher in the sulfadoxine-pyrimethamine group (44.3%). CONCLUSIONS: Intermittent preventive treatment with three doses of sulfadoxine-pyrimethamine is a more effective strategy to prevent maternal anemia during pregnancy in Burkina Faso.

Safety and immunogenicity of a recombinant Plasmodium falciparum AMA1-DiCo malaria vaccine adjuvanted with GLA-SE or Alhydrogel® in European and African adults: A phase 1a/1b, randomized, double-blind multi-centre trial.

BACKGROUND: Plasmodium falciparum Apical Membrane Antigen 1 Diversity Covering (PfAMA1-DiCo) candidate vaccine is a formulation of three recombinant variants of AMA1 designed to provide broader protection against parasites with varying AMA1 sequences. METHODS: In this staggered phase Ia/Ib randomized, double blind trial, healthy French adults received AMA1-DiCo with either Alhydrogel® (n=15) or GLA-SE (n=15). Following a safety assessment in French volunteers, GLA-SE was chosen for the phase Ib trial where healthy Burkinabe adults received either AMA1-DiCo/GLA-SE (n=18) or placebo (n=18). AMA1-DiCo (50µg) was administered intramuscularly at baseline, Week 4 and 26. RESULTS: AMAI-DiCo was safe, well tolerated either with Alhydrogel® or GLA-SE. In European volunteers, the ratios of IgG increase from baseline were about 100 fold in Alhydrogel® group and 200-300 fold in GLA-SE group for the three antigens. In African volunteers, immunization resulted in IgG levels exceeding those observed for the European volunteers with a 4-fold increase. DiCo-specific IgG remained higher 26weeks after the third immunization than at baseline in both European and African volunteers. Induced antibodies were reactive against whole parasite derived from different strains. CONCLUSION: AMA1-DiCo vaccine was safe and immunogenic whatever the adjuvant although GLA-SE appeared more potent than Alhydrogel® at inducing IgG responses. CLINICAL TRIALS REGISTRATION: ClinicalTrials.gov NCT02014727; PACTR201402000719423.

[Genetic diversity of P. falciparum and pathogenesis of the severe malarial anaemia in children under 5 years old in the province of Boulgou, Burkina Faso]. / Diversité génétique de Plasmodium falciparum et pathogénie de l'anémie palustre sévere chez des enfants de moins de 5 ans de la province du Boulgou, Burkina Faso.

The clinical presentation of malaria mainly the severe form may be related to Plasmodium falciparum msp-2 (merozoite surface protein 2) specific family To verify this hypothesis, during the high malaria transmission season in 2001; we analyzed the allelic polymorphism of the msp-2 gene of P. falciparum in children under 5 years old with different presentation of malaria in the regional Hospital and at community level in the Boulgou Province (Burkina Faso). A total of 405 children (107 severe malarial anaemia cases, 102 severe malaria cases without severe anaemia and 196 non severe malaria cases) were enrolled in the study. The frequencies of the FC27 were 89.2% in severe malarial anaemia children group, then 89.7% and 86.9% respectively in severe malaria non anaemic children cases and non severe malaria cases (P = 0.4). The frequencies of the 3D7 were 72.5%; 84.1% and 77% respectively severe malaria non anaemic children, severe malarial anaemia cases and non severe malaria cases (P = 0.7). The complexity of the FC27 genotypes was significantly higher in children with severe malaria (with and without severe anaemia) compared to the non severe malarial children (P << 0.001). No significant difference was pointed up in the complexity of the 3D7 genotypes.

Baseline immunity of the population and impact of insecticide-treated curtains on malaria infection.

It has been shown that insecticide-treated bed nets or curtains may reduce morbidity and mortality from malaria in hyper-holoendemic areas of sub-Saharan Africa. This protection could partially depend on the transitory imbalance between the anti-malaria immunity acquired by the population before the intervention and the lowered sporozoite load resulting from the anti-vector measure. To verify if the efficacy of the intervention is influenced by the baseline immune status of the population, we compared the protective effect of permethrin-impregnated curtains (PIC) against malaria infection among groups with different baseline levels of anti-malaria immunity. We analyzed the impact of PIC on the Plasmodium falciparum infection rate in two rural villages of Burkina Faso inhabited by three ethnic groups: the Fulani, Mossi, and Rimaibé. These have been previously shown to differ for several malariologic indices, with the Fulani being characterized by lower infection and disease rates and by higher immune response to P. falciparum with respect to the other ethnic groups. The PIC were distributed in June 1996 and their impact on malaria infection was evaluated in groups whose baseline levels of immunity to malaria differed because of their age and ethnic group. Age- and ethnic-dependent efficacy of the PIC was observed. Among the Mossi and Rimaibé, the impact (parasite rate reduction after PIC installation with respect to the pre-intervention surveys) was 18.8% and 18.5%, respectively. A more than two-fold general impact (42.8%) was recorded in the Fulani. The impact of the intervention on infection rates appears positively correlated with the levels of anti-malaria immunity. Since decreased transmission entails a reduction of immunity, the efficacy of the intervention in the long term cannot be taken for granted. The expected complementary role of a hypothetical vaccine is stressed by these results, which also emphasize the importance of the genetic background of the population in the evaluation and application of malaria control strategies.

In vivo sensitivity of Plasmodium falciparum to halofantrine hydrochloride in Burkina Faso.

Plasmodium falciparum susceptibility to halofantrine hydrochloride was investigated in a small village near Ouagadougou, Burkina Faso, where the parasite was known to be chloroquine resistant. An in vivo test was carried out in July 1992 at the beginning of the rainy season in children ranging in age from two to eight years with P. falciparum monospecific infections, asexual parasitemia greater than 800/microliters of blood, and a negative result on a Bergqvist urine test for 4-aminoquinolines. Among 206 children screened, 74 were selected for study. Blood samples were collected on days 0, 2, 4, 7 and 14, and 100 microscopic fields of thick and thin blood smears were examined for parasite density and species identification. Halofantrine hydrochloride was administered under supervision at the standard dose of 24 mg/kg as 8 mg/kg given three times at 6-hr intervals with an observation period of 1 hr after each 8-mg/kg dose. Parasitemias cleared in all 74 cases by day 7, but there was a recurrence of parasitemia in six subjects (8.1%) on day 14. A second course of therapy with halofantrine resulted in prompt clearance of parasitemias in all of these children. The drug was well-tolerated and the hematologic and biochemical indices were not adversely affected by treatment.

The use of impregnated curtains does not affect antibody responses against Plasmodium falciparum and complexity of infecting parasite populations in children from Burkina Faso.

In Burkina Faso, where malaria is hyper-endemic and transmission intensity is very high, the majority of malaria-related morbidity and mortality occurs in children less than 5 years of age. A control measure such as the use of insecticide-treated curtains (ITC) significantly reduces transmission of malaria infection. Concerns remain whether reduced transmission intensity may lead to a delay in the development of immunity in younger children and even to a partial loss of already acquired immunity. In this study, the levels of P. falciparum-specific IgG subclasses, the number of infecting parasite clones determined by PCR-based genotyping of the msp2 gene and the parasite density were analysed in 154 asymptomatic children (3-6 years) living in 16 villages (8 with and 8 without ITC) in the vicinity of Ouagadougou, the capital of Burkina Faso. In addition, the parasite inhibitory effects of Ig fractions, prepared from selected children, in co-operation with normal human monocytes were studied. Blood samples from asymptomatic ITC-users showed a significant decrease in P. falciparum prevalence as well as in parasite density. However, no significant difference was observed in P. falciparum-specific antibodies or in parasite multiplicity of infection between the two groups. Furthermore, Ig fractions from children of both groups showed similar levels of inhibitory activity against autologous parasite growth both on their own and in co-operation with monocytes.

Ethnobotanical survey and in vitro antiplasmodial activity of plants used in traditional medicine in Burkina Faso.

In Burkina Faso, most people in particular, in rural areas, use traditional medicine and medicinal plants to treat usual diseases. In the course of new antimalarial compounds, an ethnobotanical survey has been conducted in different regions. Seven plants, often cited by traditional practitioners and not chemically investigated, have been selected for an antiplasmodial screening: Pavetta crassipes (K. Schum), Acanthospermum hispidum (DC), Terminalia macroptera (Guill. et Perr), Cassia siamea (Lam), Ficus sycomorus (L), Fadogia agrestis (Schweinf. Ex Hiern) and Crossopteryx febrifuga (AFZ. Ex G. Don) Benth. Basic, chloroform, methanol, water-methanol and aqueous crude extracts have been prepared and tested on Plasmodium falciparum chloroquine-resistant W2 strain. A significant activity has been observed with alkaloid extract of P. crassipes (IC(50)<4 microg/ml), of A. hispidum, C. febrifuga, and F. agrestis (4

Sensitivity to antimalarial drugs by Plasmodium falciparum in Goundry, Oubritenga province, Burkina Faso.

Plasmodium falciparum susceptibility to chloroquine in vivo and to chloroquine, mefloquine, quinine, amodiaquine and sulfadoxine/pyrimethamine in vitro was investigated in children living in Goundry village, Oubritenga Province (Burkina Faso) in November 1992. An extended WHO in vivo field test was used, with follow-up on days 2, 4, 7, 14, 21 and 28 after treatment with 25 mg chloroquine per kg body weight given over 3 days, in children from 2 to 8 years old with P. falciparum monospecific infection, asexual parasitaemia > 800 parasites/microliter of blood and negative Bergqvist urine tests. At the same time, the in vitro response was assessed using WHO standard test kits. Out of the 71 in vivo responses examined, 50 (70.4%) were classified as resistant to chloroquine at RI (43.6%) or RII (26.8%) levels. There were no RIII responses. Out of the 43 isolates tested for chloroquine susceptibility in vitro, 32 (74.4%) were resistant to the drug with mean EC50 and EC99 values of 1.41 mumol and 10.96 mumol/l of blood, respectively. Resistance to sulfadoxine/pyrimethamine in vitro was observed in one out of 19 tested cases, with mean EC50 and EC99 values of 0.00002 mumol and 35.05 mumol/l of blood, respectively. All isolates were inhibited by mefloquine at 12.8 mumol/l of blood, quinine at 51.2 mumol/l of blood and amodiaquine at 0.4 mumol/l of blood, indicating full sensitivity to these 3 drugs. The present study demonstrates the high prevalence of chloroquine-resistant strains of P. falciparum in the study area of Burkina Faso and indicates that isolates resistant to sulfadoxine/pyrimethamine may also be present.

Susceptibility of Plasmodium falciparum to chloroquine and mefloquine in Ouagadougou area (Burkina Faso).

Plasmodium falciparum susceptibility to chloroquine in vivo and to chloroquine and mefloquine in vitro was investigated in children living in Ouagadougou area (Burkina Faso) in October 1991. The 7-day WHO in vivo field test was used, with follow-up on days 2, 4, 7 after treatment with 25 mg base of chloroquine per kg body weight given over 3 days, on children aged 2-8 years with monospecific P. falciparum infection (parasite density higher than 800 asexual parasites/microliters of blood), and negative Bergqvist urine tests. At the same time, the in vitro response was assessed using WHO standard test kits. Chloroquine treatment in vivo resulted in parasite clearance in 47 subjects (92.2%) within 7 days (S/RI responses). Parasitaemia did not clear in 4 cases (7.8% of RII responses). There were no RIII responses. The sensitivity study in vitro showed a low degree of chloroquine resistance in 2 out of 12 isolates tested and a mean 50% effective dose (EC50) and EC99 of 0.12 mumol and 1.47 mumol/litre of blood, respectively. All isolates tested were inhibited by mefloquine at 1.6 mumol/litre of blood, indicating full sensitivity. The present study demonstrates that first-line treatment with chloroquine is still satisfactorily effective in the study area of Burkina Faso.

Plasmodium falciparum malaria in sympatric ethnic groups of Burkina Faso, west Africa.

Plasmodium falciparum parasite rate, parasite density and anti-CS antibodies were assessed in 196 subjects (age > 10 yrs) belonging to three sympatric West African ethnic groups, namely Mossi, Rimaibé and Fulani, all exposed to very high seasonal malaria transmission in the same rural village near Ouagadougou, Burkina Faso. No interethnic differences were noted in the use of antimalaria measures nor in the exposure to malaria vectors. However, interethnic differences were found in each of the three malariological indices. The Fulani appeared markedly less parasitized and more responsive to the CS-antigen than the Mossi and the Rimaibé who had very similar indices, except in the case of parasite density. These findings suggest a higher resistance to malaria of the Fulani ethnic group, possibly involving human genetic factors and/or the influence of extrinsic variables (e.g., socio-cultural) among which diet differences should be considered.

Different response to Plasmodium falciparum in west African sympatric ethnic groups: possible implications for malaria control strategies.

The comparison of malaria indicators among populations with different genetic backgrounds and uniformly exposed to the same parasite strains, is one of the approaches to the study of human heterogeneities in the response to the infection. The results of our comparative studies conducted in Burkina Faso, West Africa, showed consistent interethnic differences in Plasmodium falciparum infection rates, malaria morbidity, prevalence and levels of antibodies to various P. falciparum antigens, and genetic background. The differences in the immune response were not explained by the entomological observations which indicated substantially uniform exposure to infective bites. The presence in the same epidemiological context of individuals characterized by different immune reactivity to malaria represents an ideal opportunity to study the possible relationships between the baseline level of anti-malaria immunity of a population and the protective efficacy of control measures based on the reduction of transmission. In spite of similar reduction of entomological inoculation rates obtained by permethrin-impregnated curtains, ethnic- and age-dependent efficacy was observed. These studies demonstrate the existence of marked interethnic differences in the susceptibility to P. falciparum malaria, probably involving the genetic regulation of humoral immune responses. These differences should be considered in the development of anti-malaria vaccines and in the evaluation and application of malaria control strategies.

Widespread distribution of insecticide-impregnated curtains reduces child mortality, prevalence and intensity of malaria infection, and malaria transmission in rural Burkina Faso.

The results of the first two years of implementation of a large scale trial of insecticide-treated curtains in Burkina Faso are summarised in this presentation. The trial was conducted in a highly malarious area and involved a population of slightly less than 100,000, distributed in 158 villages over an area of almost 1000 km2. A remarkable impact on entomological parameters (Anopheles density, sporozoite rate, entomological inoculation rate) was accompanied by a relatively modest reduction of parasitological indices (prevalence and density of Plasmodium falciparum). All-cause mortality in children 0.5 to 5 year old showed over two years a 15% decline. The authors believe that the wide surface of the protected zone and the almost total coverage achieved in the intervention villages were the major determinants of the observed reduction of transmission. A conclusive interpretation of the mortality results requires a further follow-up of the study population.

Insecticide treated curtains and allelic polymorphism of Plasmodium falciparum genes in a rural area of Burkina Faso (west Africa).

To assess the possible impact of insecticide treated curtains (ITC) on the composition of a Plasmodium falciparum population in a rural area of Burkina Faso, blood samples were collected during the rainy season of 1997 from 226 children aged 3-6 years, from 4 villages equipped with ITC and 2 control villages without ITC. The analysis of fragment lengths of 3 highly polymorphic P. falciparum genes (msp-1, msp-2 and glurp) revealed a maximum number of 3 alleles per infected person for each gene. The mean number of clones per infected person was similar in villages with and without ITC.

[Laboratory test features of newly diagnosed adult HIV-infected patients in Ouagadougou (Burkina Faso)]. / Profil biologique des patients nouvellement pris en charge pour une infection à VIH à Ouagadougou (Burkina Faso).

In a sub-Saharan African population of adults beginning care for HIV infection, we sought to describe some laboratory features and their correlation with disease progression. We retrospectively reviewed pretreatment laboratory records of recently diagnosed adults (Elisa test) beginning care at the Internal Medicine department of Yalgado Ouédraogo University Hospital between June 2009 and August 2010. The values have been classified according to WHO standards. During the study period, 177 patients were newly diagnosed as HIV-positive. Among them, 144 (81.4%) had CD4 counts below 350 cells/µL. The mean hemoglobin level was 10.3 ± 2.1 g/dL for women (n = 94) and 11.2 ± 2.8 g/dL for men (n = 67, p = 0.028), and 113 (71.1%) had anemia, 12 of them severe (7.5%). Anemia and lymphopenia were significantly correlated with a low CD4 count (p = 0.001 and 0.003 respectively). Six patients (3.4%) also had type 2 diabetes. Total cholesterol was normal in all patients, and 8 (10.4%) had hypertriglyceridemia. Hematopoietic, glycemic and lipid disorders seem relatively common in untreated black patients with HIV infection. A low CD4 count appears to predict hematopoietic cell deficits.

Distinct interethnic differences in immunoglobulin G class/subclass and immunoglobulin M antibody responses to malaria antigens but not in immunoglobulin G responses to nonmalarial antigens in sympatric tribes living in West Africa.

The well-established relative resistance to malaria observed in the Fulani as compared with other sympatric tribes in West Africa has been attributed to their higher levels of serum immunoglobulin (Ig) G antibodies to malarial antigens. In this study, we confirm and extend the previous findings by analyses of the levels of IgM, IgG and IgG subclasses of anti-malarial antibodies in asymptomatic individuals of different sympatric tribes in Burkina Faso (Fulani/Mossi) and Mali (Fulani/Dogon). The Fulani showed significantly higher median concentrations of anti-malarial IgG and IgM antibodies than the sympatric tribes at both locations. Although the overall subclass pattern of antibodies did not differ between the tribes, with IgG1 and IgG3 as dominant, the Fulani showed consistently significantly higher levels of these subclasses as compared with those of the non-Fulani individuals. No significant differences were seen in the levels of total IgG between the tribes, but the Fulani showed significantly higher levels of total IgM than their neighbours in both countries. While the antibody levels to some nonmalarial antigens showed the same pattern of differences seen for antibody levels to malaria antigens, no significant such differences were seen with antibodies to other nonmalarial antigens. In conclusion, our results show that the Fulani in two different countries show higher levels of anti-malarial antibodies than sympatric tribes, and this appears not to be a reflection of a general hyper-reactivity in the Fulani.