The AMAN study investigates how persistent, low-density malaria infections influence blood health and immune function in school-aged children in The Gambia, with a focus on susceptibility to invasive bacterial infections. While malaria is well-known for causing acute illness, many children carry subclinical infections with extremely low parasite densities that often go undetected by conventional diagnostics. Our work explores the physiological impact of these infections, particularly on neutrophils, the immune cells crucial for controlling bacterial pathogens such as non-typhoidal Salmonella (NTS), a major cause of childhood bloodstream infections in Africa.
Through large-scale community screening and detailed follow-up of children with persistent malaria, we examine how low-level parasitaemia, anaemia, and haemolysis affect neutrophil function and the body’s ability to respond to secondary bacterial infections. Early findings show that while low-density malaria alone may not impair neutrophils, resolving malaria infections can trigger transient changes in blood cell counts and immune responsiveness. These observations suggest a complex relationship where malaria infection both challenges and recalibrates the immune system, influencing susceptibility to other infections.
By understanding these subtle, often “invisible” malaria infections and their impact on immunity, the AMAN study aims to define thresholds where malaria shifts from harmless to a contributor to bacterial disease risk. This work provides critical insight into malaria immunology, host-pathogen interactions, and strategies for reducing the burden of invasive bacterial infections in malaria-endemic communities.