Children in Burkina Faso who are protected by insecticide-treated materials are able to clear drug-resistant parasites better than unprotected children.


Diallo, DA; Sutherland, C; Nebie, I; Konate, AT; Ord, R; Ilboudo-Sanogo, E; Greenwood, BM; Cousens, SN; (2007) Children in Burkina Faso who are protected by insecticide-treated materials are able to clear drug-resistant parasites better than unprotected children. The Journal of infectious diseases, 196 (1). pp. 138-44. ISSN 0022-1899 DOI: 10.1086/518252

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Abstract

BACKGROUND: It has been suggested that reducing exposure to malaria by vector control might impair the development of naturally acquired immunity to malaria. It is also thought that an individual's ability to clear drug-resistant malarial parasites after treatment is enhanced by acquired immunity. METHODS: To investigate the hypothesis that insecticide-treated materials may affect the acquisition of immunity to malaria, we compared the ability of children living in villages in which insecticide-treated curtains (ITCs) had been used for 6-8 years to clear resistant parasites after treatment with chloroquine (CQ) with that of children living in unprotected villages. RESULTS: A total of 1035 children aged 6-59 months with falciparum malaria were treated with CQ; 409 were subsequently identified as carrying parasites with the pfcrt-76T allele. More children from ITC villages cleared parasites harboring this allele than did children from non-ITC villages (34.1% vs. 24.0%; adjusted odds ratio [OR], 1.80 [95% confidence interval {CI}, 1.15-2.80]; P=.01). The difference in the clearance of parasites with the pfcrt-76T allele was seen in children aged 6-35 months (32.3% vs. 19.3%; adjusted OR, 2.34 [95% CI, 1.18-4.66]; P=.02) but not in older children (37.3% vs. 37.0%; adjusted OR, 1.09 [95% CI, 0.56-2.10]; P=.97). Rates of adequate clinical response among children carrying parasites with the pfcrt-76T allele were similar in ITC and non-ITC villages (75.1% vs. 68.6%; adjusted OR, 1.21 [95% CI, 0.61-2.39]; P=.58). CONCLUSION: Our data suggest that the children who were protected from malaria by ITCs acquired functional immunity more rapidly than did the control children.

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Faculty of Infectious and Tropical Diseases > Dept of Disease Control
Faculty of Infectious and Tropical Diseases > Dept of Immunology and Infection
Research Centre: Malaria Centre
Centre for Maternal, Reproductive and Child Health (MARCH)
Tropical Epidemiology Group
Antimicrobial Resistance Centre (AMR)
PubMed ID: 17538894
Web of Science ID: 246987100021
URI: http://researchonline.lshtm.ac.uk/id/eprint/9443

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