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Published in: Malaria Journal 1/2004

Open Access 01-12-2004 | Research

Malaria morbidity and immunity among residents of villages with different Plasmodium falciparum transmission intensity in North-Eastern Tanzania

Authors: John PA Lusingu, Lasse S Vestergaard, Bruno P Mmbando, Chris J Drakeley, Caroline Jones, Juma Akida, Zacharia X Savaeli, Andrew Y Kitua, Martha M Lemnge, Thor G Theander

Published in: Malaria Journal | Issue 1/2004

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Abstract

Background

The relationship between the burden of uncomplicated malaria and transmission intensity is unclear and a better understanding of this relationship is important for the implementation of intervention programmes.

Methods

A 6-month longitudinal study monitoring risk factors for anaemia and febrile malaria episodes was conducted among individuals aged below 20 years, residing in three villages of different altitude in areas of high, moderate and low malaria transmission intensity in North-Eastern Tanzania.

Results

The burden of anaemia and malarial fever fell mainly on the youngest children and was highest in the village with high transmission intensity. Although a considerable percentage of individuals in all villages carried intestinal worms, logistic regression models indicated that Plasmodium falciparum was the only significant parasitic determinant of anaemia. Interestingly, children who carried low-density parasitaemia at the start of the study had a lower risk of contracting a febrile malaria episode but a higher risk of anaemia during the study period, than children who were slide negative at this point in time.

Conclusion

Young children living in the high transmission village carried a very high anaemia burden, which could be attributed to malaria. The overall incidence of febrile malaria was also highest in the high transmission village particularly among those under five years of age. These data suggest that in rolling back malaria, available resources in prevention programmes should primarily be focussed on young children, particularly those residing in areas of high malaria transmission.
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Literature
1.
go back to reference Ellman R, Maxwell C, Finch R, Shayo D: Malaria and anaemia at different altitudes in the Muheza district of Tanzania: childhood morbidity in relation to level of exposure to infection. Ann Trop Med Parasitol. 1998, 92: 741-753. 10.1080/00034989858989.CrossRefPubMed Ellman R, Maxwell C, Finch R, Shayo D: Malaria and anaemia at different altitudes in the Muheza district of Tanzania: childhood morbidity in relation to level of exposure to infection. Ann Trop Med Parasitol. 1998, 92: 741-753. 10.1080/00034989858989.CrossRefPubMed
2.
go back to reference Kitua AY, Smith T, Alonso PL, Masanja H, Urassa H, Menendez C, Kimario J, Tanner M: Plasmodium falciparum malaria in the first year of life in an area of intense and perennial transmission. Trop Med Int Health. 1996, 1: 475-484. 10.1046/j.1365-3156.1996.d01-89.x.CrossRefPubMed Kitua AY, Smith T, Alonso PL, Masanja H, Urassa H, Menendez C, Kimario J, Tanner M: Plasmodium falciparum malaria in the first year of life in an area of intense and perennial transmission. Trop Med Int Health. 1996, 1: 475-484. 10.1046/j.1365-3156.1996.d01-89.x.CrossRefPubMed
3.
go back to reference Christophers SR: The mechanism of immunity against malaria in communities living under hyper-endemic conditions. Indian J Med Res. 1924, 12: 273-294. Christophers SR: The mechanism of immunity against malaria in communities living under hyper-endemic conditions. Indian J Med Res. 1924, 12: 273-294.
4.
go back to reference Bruce-Chwatt LJ: A longitudinal survey of natural malaria infection in a group of West African adults. W Afr Med J. 1963, 12: 141-173.PubMed Bruce-Chwatt LJ: A longitudinal survey of natural malaria infection in a group of West African adults. W Afr Med J. 1963, 12: 141-173.PubMed
5.
go back to reference MacDonald G: The epidemiology and control of malaria. 1957, London: Oxford University Press MacDonald G: The epidemiology and control of malaria. 1957, London: Oxford University Press
6.
go back to reference Giha HA, Rosthoj S, Dodoo D, Hviid L, Satti GMH, Scheike T, Arnot DE, Theander TG: The epidemiology of febrile malaria episodes in an area of unstable and seasonal transmission. Trans R Soc Trop Med Hyg. 2000, 94: 645-651.CrossRefPubMed Giha HA, Rosthoj S, Dodoo D, Hviid L, Satti GMH, Scheike T, Arnot DE, Theander TG: The epidemiology of febrile malaria episodes in an area of unstable and seasonal transmission. Trans R Soc Trop Med Hyg. 2000, 94: 645-651.CrossRefPubMed
7.
go back to reference Snow RW, Omumbo JA, Lowe B, Molyneux CS, Obiero JO, Palmer A, Weber MW, Pinder M, Nahlen B, Obonyo C, Newbold C, Gupta S, Marsh K: Relation between severe malaria morbidity in children and level of Plasmodium falciparum transmission in Africa. Lancet. 1997, 349: 1650-1654. 10.1016/S0140-6736(97)02038-2.CrossRefPubMed Snow RW, Omumbo JA, Lowe B, Molyneux CS, Obiero JO, Palmer A, Weber MW, Pinder M, Nahlen B, Obonyo C, Newbold C, Gupta S, Marsh K: Relation between severe malaria morbidity in children and level of Plasmodium falciparum transmission in Africa. Lancet. 1997, 349: 1650-1654. 10.1016/S0140-6736(97)02038-2.CrossRefPubMed
8.
go back to reference Snow RW, Bastos de Azevedo I, Lowe BS, Kabiru EW, Nevill CG, Mwankusye S, Kassiga G, Marsh K, Teuscher T: Severe childhood malaria in two areas of markedly different falciparum transmission in East Africa. Acta Trop. 1994, 57: 289-300. 10.1016/0001-706X(94)90074-4.CrossRefPubMed Snow RW, Bastos de Azevedo I, Lowe BS, Kabiru EW, Nevill CG, Mwankusye S, Kassiga G, Marsh K, Teuscher T: Severe childhood malaria in two areas of markedly different falciparum transmission in East Africa. Acta Trop. 1994, 57: 289-300. 10.1016/0001-706X(94)90074-4.CrossRefPubMed
9.
go back to reference Rogier C, Commenges D, Trape JF: Evidence for an age-dependent pyrogenic threshold of Plasmodium falciparum parasitemia in highly endemic populations. Am J Trop Med Hyg. 1996, 54: 613-619.PubMed Rogier C, Commenges D, Trape JF: Evidence for an age-dependent pyrogenic threshold of Plasmodium falciparum parasitemia in highly endemic populations. Am J Trop Med Hyg. 1996, 54: 613-619.PubMed
10.
go back to reference Bodker R, Akida J, Shayo D, Kisinza W, Msangeni HA, Pedersen EM, Lindsay SW: Relationship between altitude and intensity of malaria transmission in the Usambara Mountains, Tanzania. J Med Entomol. 2003, 40: 706-717.CrossRefPubMed Bodker R, Akida J, Shayo D, Kisinza W, Msangeni HA, Pedersen EM, Lindsay SW: Relationship between altitude and intensity of malaria transmission in the Usambara Mountains, Tanzania. J Med Entomol. 2003, 40: 706-717.CrossRefPubMed
11.
go back to reference Maxwell CA, Chambo W, Mwaimu M, Magogo F, Carneiro IA, Curtis CF: Variation of malaria transmission and morbidity with altitude in Tanzania and with introduction of alphacypermethrin treated nets. Malar J. 2003, 2: 28-10.1186/1475-2875-2-28.PubMedCentralCrossRefPubMed Maxwell CA, Chambo W, Mwaimu M, Magogo F, Carneiro IA, Curtis CF: Variation of malaria transmission and morbidity with altitude in Tanzania and with introduction of alphacypermethrin treated nets. Malar J. 2003, 2: 28-10.1186/1475-2875-2-28.PubMedCentralCrossRefPubMed
12.
go back to reference Balls MJ, Bodker R, Thomas CJ, Kisinza W, Msangeni HA, Lindsay SW: Effect of topography on the risk of malaria infection in the Usambara Mountains, Tanzania. Trans R Soc Trop Med Hyg. 2004, 98: 400-408. 10.1016/j.trstmh.2003.11.005.CrossRefPubMed Balls MJ, Bodker R, Thomas CJ, Kisinza W, Msangeni HA, Lindsay SW: Effect of topography on the risk of malaria infection in the Usambara Mountains, Tanzania. Trans R Soc Trop Med Hyg. 2004, 98: 400-408. 10.1016/j.trstmh.2003.11.005.CrossRefPubMed
13.
go back to reference Alifrangis M, Lemnge MM, Ronn AM, Segeja MD, Magesa SM, Khalil IF, Bygbjerg IC: Increasing prevalence of wildtypes in the dihydrofolate reductase gene of Plasmodium falciparum in an area with high levels of sulfadoxine/pyrimethamine resistance after introduction of treated bed nets. Am J Trop Med Hyg. 2003, 69: 238-243.PubMed Alifrangis M, Lemnge MM, Ronn AM, Segeja MD, Magesa SM, Khalil IF, Bygbjerg IC: Increasing prevalence of wildtypes in the dihydrofolate reductase gene of Plasmodium falciparum in an area with high levels of sulfadoxine/pyrimethamine resistance after introduction of treated bed nets. Am J Trop Med Hyg. 2003, 69: 238-243.PubMed
14.
go back to reference Schellenberg D, Schellenberg JR, Mushi A, Savigny D, Mgalula L, Mbuya C, Victora CG: The silent burden of anaemia in Tanzanian children: a community-based study. Bull World Health Organ. 2003, 81: 581-590.PubMedCentralPubMed Schellenberg D, Schellenberg JR, Mushi A, Savigny D, Mgalula L, Mbuya C, Victora CG: The silent burden of anaemia in Tanzanian children: a community-based study. Bull World Health Organ. 2003, 81: 581-590.PubMedCentralPubMed
15.
go back to reference Menendez C, Fleming AF, Alonso PL: Malaria-related Anaemia. Parasitology Today. 2000, 16: 469-476. 10.1016/S0169-4758(00)01774-9.CrossRefPubMed Menendez C, Fleming AF, Alonso PL: Malaria-related Anaemia. Parasitology Today. 2000, 16: 469-476. 10.1016/S0169-4758(00)01774-9.CrossRefPubMed
16.
go back to reference Berglund B: High-altitude training. Aspects of haematological adaptation. Sports Med. 1992, 14: 289-303.CrossRefPubMed Berglund B: High-altitude training. Aspects of haematological adaptation. Sports Med. 1992, 14: 289-303.CrossRefPubMed
17.
go back to reference Smith T, Hurt N, Teuscher T, Tanner M: Is fever a good sign for clinical malaria in surveys of endemic communities. Am J Trop Med Hyg. 1995, 52: 306-310.PubMed Smith T, Hurt N, Teuscher T, Tanner M: Is fever a good sign for clinical malaria in surveys of endemic communities. Am J Trop Med Hyg. 1995, 52: 306-310.PubMed
18.
go back to reference Trape JF, Peelman P, Morault-Peelman B: Criteria for diagnosing clinical malaria among a semi-immune population exposed to intense and perennial transmission. Trans R Soc Trop Med Hyg. 1985, 79: 435-442. 10.1016/0035-9203(85)90054-9.CrossRefPubMed Trape JF, Peelman P, Morault-Peelman B: Criteria for diagnosing clinical malaria among a semi-immune population exposed to intense and perennial transmission. Trans R Soc Trop Med Hyg. 1985, 79: 435-442. 10.1016/0035-9203(85)90054-9.CrossRefPubMed
19.
go back to reference Smith T, Schellenberg JA, Hayes R: Attributable fraction estimates and case definitions for malaria in endemic areas. Stat Med. 1994, 13: 2345-2358.CrossRefPubMed Smith T, Schellenberg JA, Hayes R: Attributable fraction estimates and case definitions for malaria in endemic areas. Stat Med. 1994, 13: 2345-2358.CrossRefPubMed
20.
go back to reference Boisier P, Jambou R, Raharimalala L, Roux J: Relationship between parasite density and fever risk in a community exposed to a low level of malaria transmission in Madagascar highlands. Am J Trop Med Hyg. 2002, 67: 137-140.PubMed Boisier P, Jambou R, Raharimalala L, Roux J: Relationship between parasite density and fever risk in a community exposed to a low level of malaria transmission in Madagascar highlands. Am J Trop Med Hyg. 2002, 67: 137-140.PubMed
21.
go back to reference Bloland PB, Boriga DA, Ruebush TK, McCormick JB, Roberts JM, Oloo AJ, Hawley W, Lal A, Nahlen B, Campbell CC: Longitudinal cohort study of the epidemiology of malaria infections in an area of intense malaria transmission II. Descriptive epidemiology of malaria infection and disease among children. Am J Trop Med Hyg. 1999, 60: 641-648.PubMed Bloland PB, Boriga DA, Ruebush TK, McCormick JB, Roberts JM, Oloo AJ, Hawley W, Lal A, Nahlen B, Campbell CC: Longitudinal cohort study of the epidemiology of malaria infections in an area of intense malaria transmission II. Descriptive epidemiology of malaria infection and disease among children. Am J Trop Med Hyg. 1999, 60: 641-648.PubMed
22.
go back to reference Beasley NM, Tomkins AM, Hall A, Kihamia CM, Lorri W, Nduma B, Issae W, Nokes C, Bundy DA: The impact of population level deworming on the haemoglobin levels of schoolchildren in Tanga, Tanzania. Trop Med Int Health. 1999, 4: 744-750. 10.1046/j.1365-3156.1999.00486.x.CrossRefPubMed Beasley NM, Tomkins AM, Hall A, Kihamia CM, Lorri W, Nduma B, Issae W, Nokes C, Bundy DA: The impact of population level deworming on the haemoglobin levels of schoolchildren in Tanga, Tanzania. Trop Med Int Health. 1999, 4: 744-750. 10.1046/j.1365-3156.1999.00486.x.CrossRefPubMed
23.
go back to reference Massaga JJ, Kitua AY, Lemnge MM, Akida JA, Malle LN, Ronn AM, Theander TG, Bygbjerg IC: Effect of intermittent treatment with amodiaquine on anaemia and malarial fevers in infants in Tanzania: a randomised placebo-controlled trial. Lancet. 2003, 361: 1853-1860. 10.1016/S0140-6736(03)13504-0.CrossRefPubMed Massaga JJ, Kitua AY, Lemnge MM, Akida JA, Malle LN, Ronn AM, Theander TG, Bygbjerg IC: Effect of intermittent treatment with amodiaquine on anaemia and malarial fevers in infants in Tanzania: a randomised placebo-controlled trial. Lancet. 2003, 361: 1853-1860. 10.1016/S0140-6736(03)13504-0.CrossRefPubMed
24.
go back to reference Schellenberg D, Menendez C, Kahigwa E, Aponte J, Vidal J, Tanner M, Mshinda H, Alonso P: Intermittent treatment for malaria and anaemia control at time of routine vaccinations in Tanzanian infants: a randomised, placebo-controlled trial. Lancet. 2001, 357: 1471-1477. 10.1016/S0140-6736(00)04643-2.CrossRefPubMed Schellenberg D, Menendez C, Kahigwa E, Aponte J, Vidal J, Tanner M, Mshinda H, Alonso P: Intermittent treatment for malaria and anaemia control at time of routine vaccinations in Tanzanian infants: a randomised, placebo-controlled trial. Lancet. 2001, 357: 1471-1477. 10.1016/S0140-6736(00)04643-2.CrossRefPubMed
25.
go back to reference Maxwell CA, Msuya E, Sudi M, Njunwa KJ, Carneiro IA, Curtis CF: Effect of community-wide use of insecticide-treated nets for 3–4 years on malarial morbidity in Tanzania. Trop Med Int Health. 2002, 7: 1003-1008. 10.1046/j.1365-3156.2002.00966.x.CrossRefPubMed Maxwell CA, Msuya E, Sudi M, Njunwa KJ, Carneiro IA, Curtis CF: Effect of community-wide use of insecticide-treated nets for 3–4 years on malarial morbidity in Tanzania. Trop Med Int Health. 2002, 7: 1003-1008. 10.1046/j.1365-3156.2002.00966.x.CrossRefPubMed
26.
go back to reference Ofori MF, Dodoo D, Staalsoe T, Kurtzhals JAL, Koram K, Theander TG, Akanmori BD, Hviid L: Malaria-induced acquisition of antibodies to Plasmodium falciparum variant surface antigens. Infect Immun. 2002, 70: 2982-2988. 10.1128/IAI.70.6.2982-2988.2002.PubMedCentralCrossRefPubMed Ofori MF, Dodoo D, Staalsoe T, Kurtzhals JAL, Koram K, Theander TG, Akanmori BD, Hviid L: Malaria-induced acquisition of antibodies to Plasmodium falciparum variant surface antigens. Infect Immun. 2002, 70: 2982-2988. 10.1128/IAI.70.6.2982-2988.2002.PubMedCentralCrossRefPubMed
Metadata
Title
Malaria morbidity and immunity among residents of villages with different Plasmodium falciparum transmission intensity in North-Eastern Tanzania
Authors
John PA Lusingu
Lasse S Vestergaard
Bruno P Mmbando
Chris J Drakeley
Caroline Jones
Juma Akida
Zacharia X Savaeli
Andrew Y Kitua
Martha M Lemnge
Thor G Theander
Publication date
01-12-2004
Publisher
BioMed Central
Published in
Malaria Journal / Issue 1/2004
Electronic ISSN: 1475-2875
DOI
https://doi.org/10.1186/1475-2875-3-26

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