title: Parasitic co-infections: does Ascaris lumbricoides protect against Plasmodium falciparum infection?
abstract: 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.
authors.affiliation: Institut de Recherche pour le Développement, Antananarivo, Madagascar.
authors.forename: Laurent
authors.initials: L
authors.lastname: Brutus
authors.forename: Laurence
authors.initials: L
authors.lastname: Watier
authors.forename: Valérie
authors.initials: V
authors.lastname: Briand
authors.forename: Virginie
authors.initials: V
authors.lastname: Hanitrasoamampionona
authors.forename: Hélène
authors.initials: H
authors.lastname: Razanatsoarilala
authors.forename: Michel
authors.initials: M
authors.lastname: Cot
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000818:Animals; D000871:Anthelmintics / Q000494:pharmacology / Q000627:therapeutic use; D001196:Ascariasis / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D017164:Ascaris lumbricoides / Q000187:drug effects / Q000276:immunology / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007978:Levamisole / Q000494:pharmacology / Q000627:therapeutic use; D016778:Malaria, Falciparum / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D008297:Male; D010270:Parasite Egg Count; D010963:Plasmodium falciparum / Q000187:drug effects / Q000276:immunology / Q000502:physiology*; D013997:Time Factors
chemical_list: D000871:Anthelmintics; D007978:Levamisole