{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:32:49Z","timestamp":1787031169923,"version":"build-2736575974"},"reference-count":21,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,3,6]]},"abstract":"<jats:p>\n                    Adults who have not grown up in a malaria-endemic area may experience severe malaria soon after entering a malarious area. Such mortality is usually limited to a short period of time (months), after which they are thought to be \u201cimmune.\u201d Such anti-disease immunity may be more accurately considered as tolerance. Malaria rates of British soldiers during the Second World War reflected their time with suppressed infections and the transmission levels. Black workers from non-endemic areas on the Panama Canal experienced higher initial mortality and infection rates than co-located white workers for\n                    <jats:italic>Plasmodium falciparum<\/jats:italic>\n                    , whereas the known genetic resistance of blacks to\n                    <jats:italic>Plasmodium vivax<\/jats:italic>\n                    reversed these rates. The ethnic differences observed in malaria rates may have more to do with acquired tolerance than genetic resistance. Long-term (years) sub-patent infections may maintain host tolerance, and elimination of malaria infections may place these adults at subsequent risk of severe malaria.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.18-0906","type":"journal-article","created":{"date-parts":[[2019,1,22]],"date-time":"2019-01-22T02:02:20Z","timestamp":1548122540000},"page":"497-500","source":"Crossref","is-referenced-by-count":10,"title":["Tolerance May Be More Appropriate Than Immunity When Describing Chronic Malaria Infections"],"prefix":"10.4269","volume":"100","author":[{"given":"George Dennis","family":"Shanks","sequence":"first","affiliation":[{"name":"Australian Defence Force Malaria and Infectious Disease Institute, Enoggera, Australia;"},{"name":"School of Public Health, University of Queensland, Brisbane, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Nat Rev Microbiol","first-page":"833","article-title":"Asymptomatic malaria infections: detectability, transmissibility and public health relevance","volume":"12","author":"Bousema","year":"2014"},{"key":"b2","series-title":"Clin Infect Dis","first-page":"628","article-title":"Postexposure administration of halofantrine for the prevention of malaria","volume":"17","author":"Shanks","year":"1993"},{"key":"b3","series-title":"Science","first-page":"936","article-title":"Disease tolerance as a defense strategy","volume":"335","author":"Medzhitov","year":"2012"},{"key":"b4","series-title":"Lancet Infect Dis","first-page":"565","article-title":"The persistence and oscillations of submicroscopic Plasmodium falciparum and Plasmodium vivax infections over time in Vietnam: an open cohort study","volume":"18","author":"Nguyen","year":"2018"},{"key":"b5","series-title":"J R Army Med Corps","first-page":"85","article-title":"John Hull Grundy lecture. 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