Beruflich Dokumente
Kultur Dokumente
ABSTRACT
Introduction: Most studies on nematode–malaria interactions were conducted outside of the
Americas. The objective of the present study was thus to study the relation between malaria and
nematodes in a cohort of children in an Amazonian village. Methods: Odds ratios for intestinal
nematode infections as an explanatory variable to malaria resistant vs. malaria sensitive were com-
puted. Results: Ascaris lumbricoides was significantly more frequent in the ‘resistant’ malaria group
than in the ‘sensitive’ one. Conclusions: Despite its low statistical power, the present results find
that Ascaris was associated with less malaria, as observed by a number of studies.
INTRODUCTION have shown that Ascaris was associated with lower in-
Gastrointestinal (GI) nematode infections and mal- cidence or prevalence of malaria [3, 4]. In contrast,
aria have a broadly overlapping distribution. A num- in Africa and Madagascar, it was observed notably
ber of studies from different continents have shown that hookworm was associated with a greater inci-
complex interactions between different GI nema- dence of malaria [5–9].
todes and malaria. These research questions have received relatively
Observational studies in Thailand showed that little attention given the omnipresence of co-infec-
Ascaris lumbricoides was associated with a dose- tions in tropical regions. The difficulty of this ques-
dependent association with protection from cerebral tion lies in the different dynamics of transmission
malaria and acute renal failure [1, 2]. Other studies between malaria and different helminths, with
C The Author [2016]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com
V 1
2 Interactions between Worms and Malaria
different immunomodulatory properties or hemato- the context of a cohort of children <7 years of age
logic consequences, which complicates the analysis living in a small Amazonian village in French Guiana.
of results. In addition, most results come from
observational studies, which are prone to biases METHODS
and confounding (nutritional status, socioeconomic The village of Camopi, located in the Oyapock mal-
level, anemia, background immunity, self-treatment, aria endemic area, consists of a central village and 28
etc.). hamlets localized within 15 km2 along the Oyapock
In French Guiana, studies performed in 2000–05 and the Camopi rivers. The village is isolated from
(unpublished data) have shown the persistence of a the coast and separated from Brazil by the Oyapock
high prevalence of GI nematode infections among river, which represents the border. The 1200 inhabit-
communities living in the interior of French Guiana, ants of Camopi are mainly Wayampi and Teko
Table 1. ORs for different GI nematodes as explanatory variables for malaria-resistant vs. malaria-
sensitive children and vivax relapse vs. no vivax relapse
GI nematodes Malaria sensitive N (%) Malaria resistant N (%) OR (95% confidence interval), p
The weakness of the present study was its sample 7. Fernandez-Nino JA, Idrovo AJ, Cucunuba ZM, et al.
size. However, despite its low statistical power, the pre- Paradoxical associations between soil-transmitted hel-
sent results also find that Ascaris was associated with minths and Plasmodium falciparum infection. Trans R Soc
Trop Med Hyg 2012;106:701–8.
less malaria, as observed by a number of studies. An
8. Hillier SD, Booth M, Muhangi L, et al. Plasmodium falcip-
interesting corollary finding was that there also seemed arum and helminth coinfection in a semi urban population
to be fewer P. vivax relapses in the Ascaris group, which of pregnant women in Uganda. J Infect Dis
would be a novel observation with intriguing implica- 2008;198:920–7.
tions on the activation of latent hypnozoites. However, 9. Pullan RL, Kabatereine NB, Bukirwa H, et al.
this observation needs to be replicated with larger sam- Heterogeneities and consequences of Plasmodium species
ple sizes. These data from South America bring add- and hookworm coinfection: a population based study in
itional data to further improve the understanding of Uganda. J Infect Dis 2011;203:406–17.