Malaria is one of the major infectious diseases in the world with a tremendous impact on the quality of life significantly contributing to the ongoing poverty in endemic countries. It causes almost one million deaths per year, the majority of which are children under the age of five. The malaria parasite enters the human body through the skin, by the bite of an infected mosquito. Subsequently, it invades the liver and develops and multiplies inside the hepatocytes. After a week, the hepatocytes burst open and the parasites are released in the blood stream, causing the clinical phase of the disease. As a unique opportunity to study malaria immunology and efficacy of immunisation strategies, a protocol has been developed in the past to conduct experimental human malaria infections (EHMIs). EHMIs generally involve small groups of malaria-naïve volunteers infected via the bites of P. falciparum infected laboratory-reared Anopheline mosquitoes. Although potentially serious or even lethal, Plasmodium falciparum (P.falciparum) malaria can be radically cured at the earliest stages of blood infection where risks of complications are virtually absent. The investigators have shown previously, that healthy human volunteers can be protected from a malaria mosquito challenge by immunization with mosquito-bites under chloroquine prophylaxis (CPS immunization). However, it is unknown whether this protection is based on immunity directed towards the liver- or the blood stage of the disease. For future development of vaccines and understanding of protective immunity to malaria, it is important to investigate at which level protective immunity is generated by CPS immunization. Therefore, we aim to investigate whether CPS immunization confers protection to a blood-stage challenge.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
SINGLE
Enrollment
25
The chloroquine dose used will be 300mg for the first two days, followed by 300mg per week, for 13 weeks.
Groups 1 and 2 will be immunized with 3 times 15 bites of Pf infected mosquitoes under chloroquine prophylaxis.
Groups 1 and 3 will be challenged by intravenous administration of Plasmodium falciparum infected erythrocytes.
Groups 2 and 4 will be challenged by the bites of 5 Plasmodium falciparum infected mosquitoes.
When thick smear positive, of ar day 21 after challenge, all volunteers will be treated with malarone.
Radboud University Nijmegen Medical Centre
Nijmegen, Netherlands
Duration of prepatent period as measured by microscopy
Time frame: 21 days after challenge
Parasitemia and kinetics of parasitemia as measured by PCR
Time frame: 21 days after challenge
Frequency of signs or symptoms in study groups
Time frame: 21 days after challenge
Antibody production in groups 1, 2, 3 and 4
Time frame: 393 days
Cellular immune response in groups 1, 2, 3 and 4
Time frame: 393 days
Cytokine profile in groups 1, 2, 3 and 4
Time frame: 393 days
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