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, Plasmodium 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 < 10(-3) at all visits), whereas it had no effect on schistosomiasis. Subjects 5-14 years of age, treated with levamisole, had a significant increase of their P. falciparum densities compared with controls (P = 0.003). There was no effect of the treatment on children 6 months to 4 years of age, nor on adults > 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.
Brutus
Laurent
L
Faculté de Pharmacie, Institut de Recherche pour le Développement, IRD UR 010, Paris, France. brutus@ird.fr
Watier
Laurence
L
Hanitrasoamampionona
Virginie
V
Razanatsoarilala
Hélène
H
Cot
Michel
M
D000293:Adolescent; D000367:Age Factors; D000818:Animals; D000871:Anthelmintics / Q000494:pharmacology / Q000627:therapeutic use; D001196:Ascariasis / Q000150:complications* / Q000188:drug therapy; D017164:Ascaris lumbricoides / Q000187:drug effects / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007978:Levamisole / Q000494:pharmacology / Q000627:therapeutic use; D008270:Madagascar; D016778:Malaria, Falciparum / Q000150:complications* / Q000188:drug therapy; D008297:Male; D010270:Parasite Egg Count; D010963:Plasmodium falciparum / Q000187:drug effects / Q000502:physiology*; D012550:Schistosoma mansoni / Q000187:drug effects; D012552:Schistosomiasis / Q000150:complications / Q000188:drug therapy; D012621:Seasons; D013997:Time Factors
D000871:Anthelmintics; D007978:Levamisole