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PARASITIC CO-INFECTIONS: DOES ASCARIS LUMBRICOIDES PROTECT AGAINST PLASMODIUM FALCIPARUM INFECTION?

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.

Received August 26, 2005. Accepted for publication December 21, 2005.

^* Address correspondence to Michel Cot, IRD UR 010, Faculté de Pharmacie, 4 Avenue de l’Observatoire, 75270 Paris Cedex 06, France. E-mail: michel.cot{at}ird.fr

Authors’ addresses: Laurent Brutus, IRD UR 010, CP 9214, La Paz, Bolivia. Laurence Watier, Inserm U 780, 16 Avenue Paul Vaillant-Couturier, 94807, Villejuif Cedex, France. Valérie Briand and Michel Cot, Institut de Recherche pour le Développement, UR 010, Faculté de Pharmacie, 4 Avenue de l’Observatoire, 75270 Paris Cedex 06, France. Virginie Hanitrasoamampionona, Hélène Razanatsoarilala, Direction de la Lutte contre les Maladies Transmissibles (DLMT), Ministère de la Santé, BP 460, 101 Antananarivo, Madagascar.

Reprint requests: Michel Cot, IRD UR 010, Faculté de Pharmacie, 4 Avenue de l’Observatoire, 75270 Paris Cedex 06, France. E-mail: michel.cot{at}ird.fr.

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