[Childhood malaria in endemic areas: epidemiology, acquired immunity and control strategies]

Malaria is a major cause of childhood mortality and morbidity in endemic areas. The incidence and severity of malaria depends on various entomological, parasitological, environmental, and human factors. Clinical presentation and epidemiologic features vary according to genetic factors, personal behavior, and immune status. Populations exposed to frequent infection may develop partial labile protective malarial immunity at the price of high morbidity and mortality due to ineffectiveness of antimalarials. Malarial immunity affects not only mortality and severity of malaria but also uncomplicated malarial attacks and plasmodium infection. The number of determining factors involved in relatively limited but, like a game of chess, their possible combinations are numerous. A better understanding of malaria is necessary to plan and implement effective control strategies. That is the aim of this review.