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Plasmodium falciparum and Schistosoma haematobium are co-endemic parasitic diseases with worldwide distribution. Evidence suggests interactions occur between helminthic and malaria infections, although it is unclear whether this effect is beneficial or harmful to the host. Malian children 4–14 years of age with asymptomatic S. haematobium infection (SP) (n = 338) were prospectively matched by age, sex, and residence to children without schistosomiasis (SN) (n = 338) who were cleared of occult intestinal parasites, and followed-up for one malaria transmission season (25 weeks). The time to the first clinical malaria infection, incidence of malaria episodes, and parasitemia were recorded. Age associated protection from malaria in children with schistosomiasis was observed. SP children (4–8 years of age) compared with SN children demonstrated delayed time to first clinical malaria infection (74 versus 59 days; P = 0.04), fewer numbers of malaria episodes (1.55 versus 1.81 infections; P = 0.03) and lower geometric mean parasite densities (6,359 versus 9,874 asexual forms/mm3; P = 0.07) at first infection. No association between schistosomiasis and P. falciparum malaria was observed in children 9–14 years of age. We conclude that underlying schistosomiasis is associated with protection against clinical falciparum malaria in an age-dependent manner.
Received April 26, 2005. Accepted for publication August 18, 2005.
Acknowledgments: We acknowledge the population of Bandiagara, Mali who continue to provide support to this and other research endeavors.
Financial support: This work was supported by a contract (N01-AI-85346) as well as a career development award (K23-AI-49203) from the National Institutes of Allergy and Infectious Diseases.
* Address correspondence to Christopher V. Plowe, Center for Vaccine Development, University of Maryland School of Medicine, 685 West Baltimore Street, HSF I, Room 480, Baltimore, MD 21201. E-mail: cplowe{at}medicine.umaryland.edu
Authors’ addresses: Kirsten E. Lyke, Marcelo B. Sztein, and Christopher V. Plowe, Center for Vaccine Development, University of Maryland School of Medicine, 685 West Baltimore Street, HSF I, Room 480, Baltimore, MD 21201, Telephone: 410-706-7376, Fax: 410-706-1204, E-mails: klyke{at}medicine.umaryland.edu, msztein{at}medicine.umaryland.edu, and cplowe{at}medicine.umaryland.edu. Alassane Dicko, Abdoulaye Dabo, Lansana Sangare, Abdoulaye Kone, Drissa Coulibaly, Ando Guindo, Karim Traore, Modibo Daou, Issa Diarra, and Ogobara K. Doumbo, Malaria Research and Training Center, Bandiagara Malaria Project, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine, Pharmacy and Dentistry, Pointe G, University of Bamako, Bamako, Mali, Telephone: 223-222-8109, E-mail: OKD{at}mrtcbko.org.
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