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Eleven years of malaria surveillance in a Sudanese village highlights unexpected variation in individual disease susceptibility and outbreak severity

Published online by Cambridge University Press:  23 August 2004

A. CREASEY ,
H. GIHA ,
A. A. HAMAD ,
I. M. EL HASSAN ,
T. G. THEANDER  and
D. E. ARNOT
A. CREASEY
Affiliation:
Institute of Cell, Animal and Population Biology, University of Edinburgh, King's Buildings, West Mains Road, Edinburgh EH9 3JT, UK
H. GIHA
Affiliation:
Biochemistry Department, University of Khartoum, Sudan
A. A. HAMAD
Affiliation:
National Malaria Administration, National Health Laboratory, Ministry of Health, Khartoum, Sudan
I. M. EL HASSAN
Affiliation:
Institute of Endemic Diseases, University of Khartoum, Sudan
T. G. THEANDER
Affiliation:
Centre for Medical Parasitology, University of Copenhagen, Denmark
D. E. ARNOT
Affiliation:
Institute of Cell, Animal and Population Biology, University of Edinburgh, King's Buildings, West Mains Road, Edinburgh EH9 3JT, UK
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Abstract

An analysis is presented of continuous data collected over 11 years based on 1902600 person/days of observation on the malaria experience of the people of Daraweesh, a village in eastern Sudan. Malaria transmission is hypo-endemic: the acquisition of clinical immunity with age is not as obvious as in more holo-endemic areas and malaria remained a problem in all age groups throughout the study. However, this population, who are of Fulani origin, showed a distinctly variable level of disease susceptibility. Thirty-two percent of the village never reported malaria symptoms or required malaria treatment while others experienced up to 8 clinical episodes over the 11 years of observation. Malaria incidence was clearly influenced by drought but much less obviously by rainfall. To what extent outbreak patterns are explicable in terms of anopheline factors, and to human immune factors, remains an interesting question for malaria modelling in this, and in other low transmission zones, such as the burgeoning urban areas of modern Africa.

Keywords

Plasmodium falciparum malariaclinical incidencelongitudinal analysisSudan
Type
Research Article
Information
Parasitology , Volume 129 , Issue 3 , September 2004 , pp. 263 - 271
Copyright
© 2004 Cambridge University Press

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