As malaria transmission falls, it is critical to understand how changing immunity affects risk of infection, clinical disease and, most importantly, treatment outcomes, because immunity has been shown to predict antimalarial treatment efficacy. ACREME will build on our current work investigating how immunity affects treatment outcomes and clearance of infection in therapeutic efficacy studies using immuno-epidemiological and spatially explicit modelling. We will extend our studies on the impact of declining transmission on malaria immunity and how that relates to risk of malaria rebound and severe disease.
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