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Acta Trop. 2001 Feb 23;78(2):139-46.

Socio-economic and environmental protective/risk factors for severe malaria in Thailand.

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  • 1Unité INSERM 511: Immunobiologie Cellulaire et Moléculaire des Infections Parasitaires, Faculté de médecine Pitié-Salpétrière, 91 boulevard de l'Hôpital, 75634 Cedex 13, Paris, France. m_nacher@mailcity.com

Abstract

We conducted a cross-sectional study to identify the socio-economic and environmental protective/risk factors for severe malaria in Thailand. Forty-six cases of severe malaria, 72 cases of non-severe malaria with high parasite biomass and 40 mild malaria cases were included. When comparing severe malaria and non-severe malaria with high parasite biomass, specific logistic regression models showed a significant protective effect for helminths, adjusted odds ratio 0.24 (0.07-0.78) for low body mass index (BMI), adjusted odds ratio 0.11 (0.02-0.58). When comparing severe and mild malaria, a longer residence duration, adjusted odds ratio 0.36 (0.09-0.83) and the use of antimalarial self-medication, adjusted odds ratio 0.08 (0.009-0.84) were associated with protection from severe malaria. Using stepwise logistic regression with all the variables inserted in the model yielded similar results. These findings suggest specific immunity and self-medication control parasite multiplication whereas helminths and malnutrition more specifically affect the pathogenesis of severe malaria.

PMID:
11230823
[PubMed - indexed for MEDLINE]
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