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Relationships between Plasmodium falciparum infection and morbidity in a highly endemic area

Published online by Cambridge University Press:  06 April 2009

T. Smith ,
B. Genton ,
K. Baea ,
N. Gibson ,
J. Taime ,
A. Narara ,
F. Al-Yaman ,
H.-P. Beck ,
J. Hii  and
M. Alpers
T. Smith
Affiliation:
Papua New Guinea Institute of Medical Research, P.O. Box 378, Madang, and P.O. Box 60, Goroka, Papua New Guinea Swiss Tropical Institute, Socinstrasse 57, Postfach, 4002 Basel, Switzerland
B. Genton
Affiliation:
Papua New Guinea Institute of Medical Research, P.O. Box 378, Madang, and P.O. Box 60, Goroka, Papua New Guinea
K. Baea
Affiliation:
Papua New Guinea Institute of Medical Research, P.O. Box 378, Madang, and P.O. Box 60, Goroka, Papua New Guinea
N. Gibson
Affiliation:
Papua New Guinea Institute of Medical Research, P.O. Box 378, Madang, and P.O. Box 60, Goroka, Papua New Guinea
J. Taime
Affiliation:
Papua New Guinea Institute of Medical Research, P.O. Box 378, Madang, and P.O. Box 60, Goroka, Papua New Guinea
A. Narara
Affiliation:
Papua New Guinea Institute of Medical Research, P.O. Box 378, Madang, and P.O. Box 60, Goroka, Papua New Guinea
F. Al-Yaman
Affiliation:
Papua New Guinea Institute of Medical Research, P.O. Box 378, Madang, and P.O. Box 60, Goroka, Papua New Guinea
H.-P. Beck
Affiliation:
Papua New Guinea Institute of Medical Research, P.O. Box 378, Madang, and P.O. Box 60, Goroka, Papua New Guinea
J. Hii
Affiliation:
Papua New Guinea Institute of Medical Research, P.O. Box 378, Madang, and P.O. Box 60, Goroka, Papua New Guinea
M. Alpers
Affiliation:
Papua New Guinea Institute of Medical Research, P.O. Box 378, Madang, and P.O. Box 60, Goroka, Papua New Guinea
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Extract

A total of 736 outpatients diagnosed as having malaria using clinical criteria at a health centre in a highly endemic area of Papua New Guinea were investigated parasitologically. Plasmodium falciparum-attributable fractions were determined using a logistic regression model to compare parasite densities in cases with those of healthy individuals in community surveys. Thirty-seven percent of presumptive cases were found to have raised P. falciparum parasitaemia. This corresponds to an average reporting rate for the population of 0·53 attributable episodes per annum. Whilst the maximum prevalence of parasitaemia in the community was in children aged 5–9 years, the maximum age-specific incidence of attributable cases at the outpatient clinic was 2 cases per annum in the 2- to 4-year-old age group. The procedure for estimating attributable fractions makes it possible to compare morbidity rates between age groups, and to examine how the relationship between morbidity risk and parasite density changes with age, without diagnosing individual episodes. The average tolerance of parasites in an age group was measured by considering the level of parasitaemia associated with a given risk of malaria-attributable morbidity. In contrast to anti-parasite immunity, tolerance of parasites declines with age since at parasite isodensity the probability of being symptomatic increases with age.

Keywords

malariaepidemiologydiagnosisparasitaemiaPapua New Guinea
Type
Research Article
Information
Parasitology , Volume 109 , Issue 5 , December 1994 , pp. 539 - 549
Copyright
Copyright © Cambridge University Press 1994

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References

REFERENCES

Alpers, M. P., Al-Yaman, F., Beck, H.-P., Bhatia, K., Hii, J., Lewis, D., Paru, R. & Smith, T. (1992). The malaria vaccine epidemiology and evaluation project of PNG: rationale and baseline studies. Papua New Guinea Medical Journal 35, 285–97.Google Scholar
Armstrong Schellenberg, J. R. M., Smith, T., Alonso, P. L. & Hayes, R. J. (1994). What is clinical malaria? Finding case definitions for field research in highly endemic areas. Parasitology Today (in the Press).Google Scholar
Baird, J. K., Purnomo, H. B., Bangs, M. J., Andersen, E. M., Jones, T. R., Masbar, S., Harjosuwano, S., Subianto, B. & Arbani, P. R. (1993). Age-specific prevalence of Plasmodium falciparum among six populations with limited histories of exposure to endemic malaria. American Journal of Tropical Medicine and Hygiene 49, 707–19.CrossRefGoogle ScholarPubMed
Baird, J. K., Trevor, R. J., Danudirgo, E. W., Annie, B. A., Bangs, M. J., Purnomo, H. B. & Masbar, S. (1991). Age-dependent acquired protection against Plasmodium falciparum in people having two years exposure to hyperendemic malaria. American Journal of Tropical Medicine and Hygiene 45, 65–76.CrossRefGoogle ScholarPubMed
Bate, C. A. W., Taverne, J., Dave, A. & Playfair, J. H. L. (1990). Malaria exoantigens induce T-independent antibody that blocks their ability to induce TNF. Immunology 70, 315–20.Google ScholarPubMed
Bruzzi, P., Green, S., Byar, D. P., Brinton, L. A. & Schairer, C. (1985). Estimating the population attributable risk for multiple risk factors using case-control data. American Journal of Epidemiology 122, 904–14.CrossRefGoogle ScholarPubMed
Burkot, T. R., Graves, P. M., Cattani, J. A., Wirtz, R. A. & Gibson, P. D. (1987). The efficiency of sporozoite transmission in the human malarias, Plasmodium falciparum and P. vivax. Bulletin of the World Health Organization 65, 375–80.Google ScholarPubMed
Cattani, J. A., Tulloch, J. L., Vrbova, H., Jolley, D., Gibson, F. D., Moir, J. S., Heywood, P. F., Alpers, M. P., Stevenson, A. & Clancy, R. (1986). The epidemiology of malaria in a population surrounding Madang, Papua New Guinea. American Journal of Tropical Medicine and Hygiene 35, 3–15.CrossRefGoogle Scholar
Charlwood, J. D., Graves, P. M. & Alpers, M. P. (1986). The ecology of the Anopheles punctulatus group of mosquitoes from Papua New Guinea: a review of recent work. Papua New Guinea Medical Journal 29, 19–26.Google ScholarPubMed
Chougnet, C., Deloron, P. & Savel, J. (1991). Persistence of cellular and humoral response to synthetic peptides from defined Plasmodium falciparum antigens. Annals of Tropical Medicine and Parasitology 85, 357–63.CrossRefGoogle ScholarPubMed
Clark, I. A. & Chaudhri, G. (1989). Relationships between inflammation and immunopathology of malaria. In Malaria: Host Responses to Infection (ed. Stevenson, M. M.), pp. 127–146. Boca Raton: CRC Press.Google Scholar
Cox, M. J., Kum, D., Tavul, L., Narara, A., Raiko, A., Baisor, M., Alpers, M., Medley, G. & Day, K. P. (1994). Dynamics of malaria parasitaemia associated with febrile illness in children from a rural area of Madang, Papua New Guinea. Transactions of the Royal Society of Tropical Medicine and Hygiene (in the Press).CrossRefGoogle ScholarPubMed
Day, K. P. & Marsh, K. (1991). Naturally acquired immunity to Plasmodium falciparum. Immunology Today 7, A68–A71.CrossRefGoogle Scholar
Deloron, P., Le Bras, J., Savel, J. & Coulaud, J. P. (1987). Antibodies to the PF155 antigen of Plasmodium falciparum: measurement by cell-ELISA and correlation with expected immune protection. American Journal of Tropical Medicine and Hygiene 37, 22–6.CrossRefGoogle Scholar
Felger, I., Tavul, L., Kabintik, S., Marshall, V., Genton, B., Alpers, M. & Beck, H.-P. (1994). Plasmodium falciparum: extensive polymorphism in merozoite surface antigen 2 alleles in an area with endemic malaria in Papua New Guinea. Experimental Parasitology (in the Press).CrossRefGoogle Scholar
Garner, P. A. (1989). The Epidemiology of Maternal and Neonatal Health in Papua New Guinea. Ph.D. thesis. University of London.Google Scholar
Genton, B., Smith, T., Baea, K., Narara, A., Al-Yaman, F., Beck, H.-P., Hii, J. & Alpers, M. (1994). How useful are clinical criteria for improving the diagnosis of malaria among presumptive cases in a highly endemic area of Papua New Guinea? Transactions of the Royal Society of Tropical Medicine and Hygiene (in the Press).CrossRefGoogle Scholar
Greenwood, B. M. (1987). Asymptomatic malaria infections – Do they matter? Parasitology Today 3, 206–14.CrossRefGoogle ScholarPubMed
Greenwood, B. M., Bradley, A. K., Greenwood, A. M., Byass, P., Jammeh, K., Marsh, K., Tulloch, S., Oldfield, F. S. J. & Hayes, R. (1987). Mortality and morbidity from malaria among children in a rural area of The Gambia, West Africa. Transactions of the Royal Society of Tropical Medicine and Hygiene 81, 478–86.CrossRefGoogle Scholar
Kemp, C. H., Silver, H. K. & O'Brian, D. (1978). Current Pediatric Diagnosis and Treatment, 5th Edn.Los Altos: Lange Medical Publications.Google Scholar
Kwiatkowski, D. (1989). Febrile temperatures can synchronise the growth of Plasmodium falciparum in vitro. Journal of Experimental Medicine 169, 357–61.CrossRefGoogle ScholarPubMed
Kwiatkowski, D. (1991). Cytokines and anti-disease immunity to malaria. Research in Immunology 142, 707–12.CrossRefGoogle ScholarPubMed
McGregor, I. A. (1983). Current concepts concerning man's resistance of infection with malaria. Bulletin de la Société de Pathologie Exotique 76, 433–45.Google ScholarPubMed
McGregor, I. A. & Wilson, R. J. M. (1988). Specific immunity: acquired in man. In Malaria, Principles and Practice of Malariology (ed. Wernsdorfer, W. H. & McGregor, I.), pp. 559–620. Edinburgh: Churchill Livingstone.Google Scholar
Marsh, K. (1992). Malaria – a neglected disease? Parasitology 104, S53–S65.CrossRefGoogle ScholarPubMed
Miller, M. J. (1958). Observations of the natural history of malaria in the semi-resistant West African. Transactions of the Royal Society of Tropical Medicine and Hygiene 52, 152–68.CrossRefGoogle ScholarPubMed
Molineaux, L. (1988). The epidemiology of human malaria as an explanation of its distribution, including some implications for its control. In Malaria, Principles and Practice of Malariology (ed. Wernsdorfer, W. H. & McGregor, I.), pp. 913–998. Edinburgh: Churchill Livingstone.Google Scholar
Olivar, M., Develoux, M., Agari, A. C. & Loutan, L. (1991). Presumptive diagnosis of malaria results in a significant risk of mistreatment of children in urban Sahel. Transactions of the Royal Society of Tropical Medicine and Hygiene 85, 729–30.CrossRefGoogle Scholar
Papua New Guinea Department Of Health (1989). Standard Treatment for Common Illnesses of Adults in Papua New Guinea, 4th Edn.Port Moresby: Department of Health.Google Scholar
Petersen, E., Hogh, B., Marbiah, N. T., David, K. & Hanson, A. P. (1991 a). Development of immunity against Plasmodium falciparum malaria: clinical and parasitologic immunity cannot be separated. Journal of Infectious Diseases 164, 949–53.CrossRefGoogle ScholarPubMed
Petersen, E., Hogh, B., Marbiah, N. T., Dolopaie, E., Gottshau, A., Hanson, A. P. & Bjorkman, A. (1991 b). Clinical and parasitological studies on malaria in Liberian adults living under intense malaria transmission. Annals of Tropical Medicine and Parasitology 85, 577–84.CrossRefGoogle ScholarPubMed
Playfair, J. H. L., Taverne, J., Bate, C. A. W. & De Souza, J. B. (1990). The malaria vaccine: anti-parasite or anti-disease? Immunology Today 11, 25–7.CrossRefGoogle ScholarPubMed
Rooth, I. B. & Bjorkman, A. (1992). Suppression of Plasmodium falciparum infections during concomitant measles or influenza but not during pertussis. American Journal of Tropical Medicine and Hygiene 47, 675–81.CrossRefGoogle Scholar
Selwyn, B. J. (1990). The epidemiology of acute respiratory tract infection in young children: comparison of findings from several developing countries. Reviews of Infectious Disease 12 (Suppl. 18), S870–S888.CrossRefGoogle ScholarPubMed
Shute, G. T. (1988). The microscopic diagnosis of malaria. In Malaria, Principles and Practice of Malariology (ed. Wernsdorfer, W. H. & McGregor, I.), pp. 781–814. Edinburgh: Churchill Livingstone.Google Scholar
Smith, T., Armstrong Schellenberg, J. R. M. & Hayes, R. (1994). Attributable fraction estimates and case definitions for malaria in endemic areas. Statistics in Medicine (in the Press).CrossRefGoogle ScholarPubMed
Smith, T., Lehmann, D., Coakley, C., Spooner, V. & Alpers, M. P. (1991). Relationships between growth and acute lower respiratory infections among children under five years of age in a highland population of Papua New Guinea. American Journal of Clinical Nutrition 53, 963–70.CrossRefGoogle Scholar
Snow, R. W., Lindsay, S. W., Hayes, R. J. & Greenwood, B. M. (1988). Permethrin-treated bed nets (mosquito nets) prevent malaria in Gambian children. Transactions of the Royal Society of Tropical Medicine and Hygiene 82, 838–42.CrossRefGoogle ScholarPubMed
Trape, J. F., Peelman, P. & Mozault-Peelman, B. (1985). Criteria for diagnosing clinical malaria among a semi-immune population exposed to intense and perennial transmission. Transactions of the Royal Society of Tropical Medicine and Hygiene 79, 435–42.CrossRefGoogle ScholarPubMed
Trape, J. F., Zoulani, A. & Quinet, M. C. (1987). Assessment of the incidence and prevalence of clinical malaria in semi-immune children exposed to intense and perennial transmission. American Journal of Epidemiology 126, 193–201.CrossRefGoogle ScholarPubMed
Vince, J. D. (1992). Malaria in children in Papua New Guinea. Papua New Guinea Medical Journal 35, 258–63.Google ScholarPubMed
Wilson, D. B., Garnham, P. C. C. & Swellengrebel, N. H. (1950). A review of hyperendemic malaria. Tropical Diseases Bulletin 47, 677–98.Google ScholarPubMed