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Decreased Mortality of falciparum Malaria in Anemic Prisoners of War?

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  • 1 Australian Defence Force Malaria and Infectious Disease Institute, Enoggera, Australia;
  • | 2 School of Public Health, University of Queensland, Brisbane, Australia

ABSTRACT

Modern clinical trials have suggested that anemia protects against malaria mortality. Military records of the Second World War in Asia were examined to see if there was support for this hypothesis. When relatively well-nourished Imperial Japanese Navy sailors captured on Nauru (n = 799) were imprisoned on the Fauro Islands, 26% died from falciparum malaria. Similarly treated but very malnourished colocated Imperial Army soldiers experienced low stable malaria mortality. One-fifth of previously healthy Australian Army soldiers (n = 252) retreating from New Britain died largely because of malaria in April 1942. Malnourished prisoners of war, who were as a group very anemic, both Australian Army soldiers in Thailand and Japanese Army soldiers in Papua New Guinea, had high malaria rates but very low (< 3%) mortality rates. Malaria immunity does not adequately explain this dichotomy, suggesting that severe nutritional deprivation may be protective against malaria mortality possibly because of iron-deficiency anemia.

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Author Notes

Address correspondence to George Dennis Shanks, Australian Defence Force Malaria and Infectious Disease Institute, Weary Dunlop Dr., Gallipoli Barracks, Enoggera 4051, Australia. E-mail: dennis.shanks@defence.gov.au

Disclaimer: The opinions expressed are those of the author and do not necessarily reflect those of the Australian Defence Force or the U.S. Department of Defense.

Disclosure: The author is an employee of the Australian Defense Organization and a retired U.S. Army medical officer.

Author’s addresses: George Dennis Shanks, Australian Defence Force Malaria and Infectious Disease Institute, Enoggera, Australia, and School of Public Health, University of Queensland, Brisbane, Australia, E-mail: dennis.shanks@defence.gov.au.

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