Association of helminth infections with increased gametocyte carriage during mild falciparum malaria in Thailand.

M NacherUnité Institut National de la Santé et de la Recherche Médicale 511, Immunobiologie Cellulaire et Moléculaire des Infections Parasitaires, Faculté de Médecine Pitié-Salpétrière, Paris, France.

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P SinghasivanonUnité Institut National de la Santé et de la Recherche Médicale 511, Immunobiologie Cellulaire et Moléculaire des Infections Parasitaires, Faculté de Médecine Pitié-Salpétrière, Paris, France.

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U SilachamroonUnité Institut National de la Santé et de la Recherche Médicale 511, Immunobiologie Cellulaire et Moléculaire des Infections Parasitaires, Faculté de Médecine Pitié-Salpétrière, Paris, France.

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S TreeprasertsuUnité Institut National de la Santé et de la Recherche Médicale 511, Immunobiologie Cellulaire et Moléculaire des Infections Parasitaires, Faculté de Médecine Pitié-Salpétrière, Paris, France.

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S KrudsoodUnité Institut National de la Santé et de la Recherche Médicale 511, Immunobiologie Cellulaire et Moléculaire des Infections Parasitaires, Faculté de Médecine Pitié-Salpétrière, Paris, France.

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F GayUnité Institut National de la Santé et de la Recherche Médicale 511, Immunobiologie Cellulaire et Moléculaire des Infections Parasitaires, Faculté de Médecine Pitié-Salpétrière, Paris, France.

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D MazierUnité Institut National de la Santé et de la Recherche Médicale 511, Immunobiologie Cellulaire et Moléculaire des Infections Parasitaires, Faculté de Médecine Pitié-Salpétrière, Paris, France.

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S LooareesuwanUnité Institut National de la Santé et de la Recherche Médicale 511, Immunobiologie Cellulaire et Moléculaire des Infections Parasitaires, Faculté de Médecine Pitié-Salpétrière, Paris, France.

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The objective of this study was to determine whether pre-existing helminth infections could affect sexual forms of Plasmodium falciparum. A cross-sectional case record study compared 120 mild P. falciparum malaria cases with patent gametocyte carriage and 187 without gametocytes for helminth exposure. Relevant crude odds ratios and potential confounders were included in a logistic regression model. Helminth infections were associated with the presence of gametocytes with a crude odds ratio of 1.9 (95% confidence interval = 1.1-3.3) (P = 0.01). A positive linear trend was observed between the odds of having patent gametocytemia and the number of different helminth species (P = 0.003). However, when adjusting for hemoglobin concentration the significance of the association between helminths and gametocytes disappeared (P = 0.15). Pre-existing helminth infections may increase the severity of malarial anemia and therefore increase the likelihood of carrying gametocytes. At a population level, helminth infections may thus have a significant influence on malaria transmission.

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