Evidence for Specific Suppression of Gametocytemia by Plasmodium Falciparum in Residents of Hyperendemic Irian Jaya

J. Kevin BairdU.S. Naval Medical Research Unit No. 2, Jakarta Detachment, Jakarta, Indonesia

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Trevor R. JonesU.S. Naval Medical Research Unit No. 2, Jakarta Detachment, Jakarta, Indonesia

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Purnomo S. MasbarU.S. Naval Medical Research Unit No. 2, Jakarta Detachment, Jakarta, Indonesia

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S. RatiwayantoU.S. Naval Medical Research Unit No. 2, Jakarta Detachment, Jakarta, Indonesia

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B. LeksanaU.S. Naval Medical Research Unit No. 2, Jakarta Detachment, Jakarta, Indonesia

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An epidemiologic study of hyperendemic malaria in Arso PIR, a village in northeastern Irian Jaya (Indonesian New Guinea), revealed evidence suggesting suppression of gametocytemia independent of immune control of the asexual parasitemia. A total of 240 people, representing ages between 2 and 60 years, were followed by biweekly blood film examination for 16 weeks beginning in November 1987. Two distinct subpopulations were represented — 1) life-long residents of Irian Jaya, and 2) transmigrants from Java who arrived in Irian Jaya 20 months before the surveillance effort began. Twenty-five percent of blood films from natives and 31% from Javanese were positive for falciparum malaria; of these, the rate of gametocytemia was 21% for natives, and 42% for the Javanese transmigrants (P < 0.001). This difference could not be explained by differences in the frequency or grade of parasitemia, illness, or by known patterns of antimalarial consumption. Similarly, in Wor, a village near Arso PIR, the gametocyte rate for P. falciparum diminished from 83% to 25% in transmigrants from Java between their eleventh and twenty-fifth month of residence in Irian Jaya, a period during which the falciparum malaria rate remained stable between 30% and 50%. An immunofluorescent antibody test using whole, acetone-fixed gametocytes as substrate revealed correlation between antibody titer and protection from gametocytemia among the semi-immune natives of Arso PIR, but not among the Javanese. Specific immune suppression of gametocytes, independent of immune control of asexual parasites, can explain all of these observations.

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