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Am. J. Trop. Med. Hyg., 77(6), 2007, pp. 1091-1095
Copyright © 2007 by The American Society of Tropical Medicine and Hygiene

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Confirmation of the Protective Effect of Ascaris lumbricoides on Plasmodium falciparum Infection: Results of a Randomized Trial in Madagascar

Laurent Brutus*, Laurence Watier, Virginie Hanitrasoamampionona, Hélène Razanatsoarilala, AND Michel Cot
Institut de Recherche pour le Développement, IRD UR 010, Paris, France; INSERM U 780–IFR 69, Villejuif, France; Ministry of Health, Direction de la Lutte contre les Maladies Transmissibles, Antananarivo, 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.

Received May 24, 2007. Accepted for publication June 22, 2007.

* Address correspondence to Laurent Brutus, IRD UR 010, Laboratoire de Parasitologie, Faculté de Pharmacie Paris V, 4 avenue de l’Observatoire, Paris 75006, France. E-mail: brutus{at}ird.fr

Authors’ addresses: Michel Cot and Laurent Brutus, IRD UR 010, Faculté de Pharmacie, 4 avenue de l’Observatoire, 75270 Paris Cedex 06, France. Laurence Watier, Inserm U 780, IFR 69, 16 avenue Paul Vaillant-Couturier, 94807 Villejuif Cedex, France. Virginie Hanitrasoamampionona and Hélène Razanatsoarilala, Ministry of Health, Direction de la Lutte contre les Maladies Transmissibles (DLMT), BP 460, 101 Antananarivo, Madagascar.






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Copyright © 2007 by the American Society of Tropical Medicine and Hygiene.