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The blood stage of<jats:italic>Plasmodium<\/jats:italic>parasite is entirely responsible for malaria-associated pathology. Disease syndromes range from fever to more severe complications, including respiratory distress, metabolic acidosis, renal failure, pulmonary oedema and cerebral malaria. The most susceptible population to severe malaria is children under the age of 5, with low levels of immunity. It is only after many years of repeated exposure, that individuals living in endemic areas develop clinical immunity. This form of protection does not result in sterilizing immunity but prevents clinical episodes by substantially reducing parasite burden. Naturally acquired immunity predominantly targets blood-stage parasites and it is known to require antibody responses. A large body of epidemiological evidence suggests that antibodies to<jats:italic>Plasmodium<\/jats:italic>antigens are inefficiently generated and rapidly lost in the absence of ongoing exposure, which suggests a defect in the development of B cell immunological memory. This review summarizes the main findings to date contributing to our understanding on cellular processes underlying the slow acquisition of humoral immunity to malaria. Some of the key outstanding questions in the field are discussed.<\/jats:p>","DOI":"10.1017\/s0031182015001705","type":"journal-article","created":{"date-parts":[[2016,1,8]],"date-time":"2016-01-08T10:12:49Z","timestamp":1452247969000},"page":"199-207","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":40,"title":["Immunological processes underlying the slow acquisition of humoral immunity to malaria"],"prefix":"10.1017","volume":"143","author":[{"given":"VICTORIA","family":"RYG-CORNEJO","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ANN","family":"LY","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"DIANA 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