Confirmation of the protective effect of Ascaris lumbricoides on Plasmodium falciparum infection : results of a randomized trial in Madagascar

A controlled randomized trial of anti-helminthic treatment was undertaken in 1996-1997 in a rural area of Madagascar where populations were simultaneously infected with Ascaris lumbricoides, Plasmodiurn falciparum, and Schistosoma mansoni. Levamisole was administered bimonthly to 107 subjects, whereas 105 were controls. Levamisole was highly effective in reducing Ascaris egg loads in the treated group (P 15 years of age. This study confirms the results of a randomized trial, which showed a negative interaction in those > 5 years of age between Ascaris and malaria parasite density in another Malagasy population, submitted to a higher malaria transmission

Parasitic co-infections : does Ascaris lumbricoides protect against Plasmodium falciparum infection ?

A controlled randomized trial of antihelminthic treatment was undertaken in 1996-1997 in a rural area of Madagascar where populations were simultaneously infected with Ascaris lumbricoides and Plasmodium falciparum. Levamisole was administered bimonthly to 164 subjects, randomized on a family basis, whereas 186 were controls. While levamisole proved to be highly effective in reducing Ascaris egg loads in the treated group (P < 10(-3) at all bimonthly visits), subjects more than 5 years of age, treated with levamisole had a significant increase in their P. falciparum densities compared with controls (P = 0.02), whereas there was no effect of anti-helminthic treatment on children 6 months to 4 years of age. The demonstration of a clear negative interaction between Ascaris infection and malaria parasite density has important implications. Single community therapy programs to deliver treatments against several parasitic infections could avoid an increase of malaria attacks after mass treatment of ascariasis

Etude épidémiologique des principales nématodoses intestinales humaines dans le Moyen-ouest de Madagascar

Une enquête épidémiologique descriptive concernant les géohelminthes a été réalisée durant les mois de juillet et août 1995 dans le Moyen-ouest de Madagascar. 4571 adultes et enfants âgés de 6 mois à 90 ans ont été inclus dans cette étude qui a concerné 61 villages répartis entre les villes de Betafo et Miandrivazo. L'examen des échantillons de selles par la méthode du MIF concentration a révélé que l'ascaris est le nématode intestinal prédominant dans cette région, en particulier dans les villages d'altitude. Les prévalences d'#Ascaris lumbricoides$sont maximales chez les enfants et les sujets de sexe féminin. Cette parasitose, qui touche plus de 50$ sont plus basses que celles des deux autres nématodoses dans tous les villages. D'importantes variations des prévalences des géohelminthes sont observées selon les régions en relation avec les facteurs climatiques. (Résumé d'auteur

Maladies transmissibles et environnement : table-ronde

The enhancement of the agricultural space, the developpement of urbanized areas are as many factors which are modifying the epidemiology of many pathologies. These processes are particularly important in developing countries. Unfortunately, even if the health consequences of the environnemental changes become present preoccupation of imported large development programs, they are considered most of the time as marginal when these modification processes occur within "traditional" social groups. For now, the very few important development projects in Madagascar especially found in the coast areas. Most of the rural population live poorly with real difficulties. But the health consequences of the processes of environment management are taken into account only by the existing development projects. Nevertheless the stakes to work out public health strategies are considerable. The discussion is focused on a geographical and medical survey which was conducted during July and August 1995 in 61 villages located in the highlands and the middle west of Madagascar. The results obtained during that survey revealed the main health differences in the study area. In regard to these spatial health variations, it is now possible to begin to explore the link between health and environment. (Résumé d'auteur

Maladies transmissibles et environnement : table-ronde

The enhancement of the agricultural space, the developpement of urbanized areas are as many factors which are modifying the epidemiology of many pathologies. These processes are particularly important in developing countries. Unfortunately, even if the health consequences of the environnemental changes become present preoccupation of imported large development programs, they are considered most of the time as marginal when these modification processes occur within "traditional" social groups. For now, the very few important development projects in Madagascar especially found in the coast areas. Most of the rural population live poorly with real difficulties. But the health consequences of the processes of environment management are taken into account only by the existing development projects. Nevertheless the stakes to work out public health strategies are considerable. The discussion is focused on a geographical and medical survey which was conducted during July and August 1995 in 61 villages located in the highlands and the middle west of Madagascar. The results obtained during that survey revealed the main health differences in the study area. In regard to these spatial health variations, it is now possible to begin to explore the link between health and environment. (Résumé d'auteur