Socio-economic and environmental protective/risk factors for severe malaria in Thailand

• Main Authors: Mathieu Nacher, Pratap Singhasivanon, Suparp Vannaphan, Sombat Treeprasertsuk, Maninthorn Phanumaphorn, Boubacar Traore, Sornchai Looareesuwan, Frédérick Gay
• Other Authors: Faculte de Medecine Pierre et Marie Curie
• Format: Conference or Workshop Item
• Published: 2018
• Subjects: Agricultural and Biological Sciences; Immunology and Microbiology; Medicine; Veterinary
• Online Access: https://repository.li.mahidol.ac.th/handle/123456789/26404
• Institution: Mahidol University

We conducted a cross-sectional study to identify the socio-economic and environmental protective/risk factors for severe malaria in Thailand. Forty-six cases of severe malaria, 72 cases of non-severe malaria with high parasite biomass and 40 mild malaria cases were included. When comparing severe malaria and non-severe malaria with high parasite biomass, specific logistic regression models showed a significant protective effect for helminths, adjusted odds ratio 0.24 (0.07-0.78) for low body mass index (BMI), adjusted odds ratio 0.11 (0.02-0.58). When comparing severe and mild malaria, a longer residence duration, adjusted odds ratio 0.36 (0.09-0.83) and the use of antimalarial self-medication, adjusted odds ratio 0.08 (0.009-0.84) were associated with protection from severe malaria. Using stepwise logistic regression with all the variables inserted in the model yielded similar results. These findings suggest specific immunity and self-medication control parasite multiplication whereas helminths and malnutrition more specifically affect the pathogenesis of severe malaria. © 2001 Elsevier Science B.V.