title: Intestinal helminths and malnutrition are independently associated with protection from cerebral malaria in Thailand.
abstract: Although human infection with Ascaris appears to be associated with protection from cerebral malaria, there are many potential socio-economic and nutritional confounders related to helminth infection that need to be considered. In a hospital-based study, 37 cases of cerebral malaria and 61 cases of non-severe malaria with high parasite biomass (i.e. hyperparasitaemia and/or circulating schizonts) answered a structured questionnaire and were screened for intestinal helminths. Logistic regression was then used to adjust for the potential confounders. The adjusted odds ratios (OR) and their 95% confidence intervals (CI) still showed a significant protective association for helminths (OR = 0.24; CI = 0.07-0.78, P = 0.02) and malnutrition (OR = 0.11; CI = 0.02-0.58; P = 0.01), with no evidence of interaction between the two. There was also a significant dose-effect trend for the helminth infections (P = 0.048). These results, despite coming from a hospital-based study, indicate that the apparent association between helminths and protection from cerebral malaria is not the result of socio-economic or nutritional confounders.
authors: Unité INSERM 511, Immunobiologie Cellulaire et Moléculaire des Infections Parasitaires, CHRU Pitié-Salpétrière, Paris, France. m_nacher@lycos.com
authors: M
authors: M
authors: Nacher
authors: P
authors: P
authors: Singhasivanon
authors: S
authors: S
authors: Treeprasertsuk
authors: S
authors: S
authors: Vannaphan
authors: B
authors: B
authors: Traore
authors: S
authors: S
authors: Looareesuwan
authors: F
authors: F
authors: Gay
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002448:Cell Adhesion; D003430:Cross-Sectional Studies; D006373:Helminthiasis / Q000150:complications* / Q000469:parasitology; D006801:Humans; D007411:Intestinal Diseases, Parasitic / Q000150:complications* / Q000469:parasitology; D016779:Malaria, Cerebral / Q000150:complications*; D009748:Nutrition Disorders / Q000150:complications*; D016017:Odds Ratio