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15 May 2005

Volume 191, Number 10
The Journal of Infectious Diseases 2005;191:1589–1598
© 2005 by the Infectious Diseases Society of America. All rights reserved.
0022-1899/2005/19110-0004$15.00
DOI: 10.1086/429669
MAJOR ARTICLE

Altitude‐Dependent and ‐Independent Variations in Plasmodium falciparum Prevalence in Northeastern Tanzania

Chris J. Drakeley,1,5

Ilona Carneiro,5

Hugh Reyburn,1,5

Robert Malima,1,3

John P. A. Lusingu,3,4

Jonathan Cox,5

Thor G. Theander,4

Watoky M. M. M. Nkya,2

Martha M. Lemnge,3 and

Eleanor M. Riley5

1Joint Malaria Programme and 2Kilimanjaro Christian Medical Centre, Moshi, and 3National Institute for Medical Research, Amani Medical Research Centre, Amani, Tanzania; 4Centre for Medical Parasitology, University of Copenhagen, Panum Institute, Copenhagen, Denmark; 5Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom

Background.Effective malaria control requires information about intensity of transmission across large areas and populations. Estimates based on entomological factors lack precision and are not cost‐effective to obtain. We tested altitude and rainfall measurements as correlates of transmission intensity in different ecological settings.

Methods.We conducted 2 cross‐sectional surveys of 12,000 people (1–45 years old) in 6 altitude transects (150–1800 m) in the Kilimanjaro and Tanga regions of Tanzania. Data were analyzed for associations with altitude and rainfall estimates by use of appropriate regression models.

Results.Plasmodium falciparum prevalence showed a negative relationship with altitude (19% and 21% decrease/100‐m altitude increase, respectively, in children in Kilimanjaro and Tanga) and rainfall during the 3 months before the survey (46% decrease/100‐mm rainfall increase in children in Kilimanjaro). Mean hemoglobin concentrations increased with altitude (0.05 and 0.09 g/dL/100‐m altitude increase, respectively, in children in Kilimanjaro and Tanga) and rainfall (0.17 g/dL/100‐mm rainfall increase in children and adults in Kilimanjaro).

Discussion.Altitude and rainfall were correlated with parasite prevalence and mean hemoglobin concentration; however, the relationship varied according to ecological setting. Climatological variables alone cannot predict malarial outcomes. Local variations in seasonality of malaria transmission—together with vector species composition, topography, host and parasite genetics, and socioeconomic factors—may influence malaria prevalence.

Received 14 September 2004; accepted 14 December 2004; electronically published 7 April 2005.

Reprints or correspondence: Dr. Chris J. Drakeley, Joint Malaria Programme, Box 2228, Moshi, Tanzania ().

Cited by

Anders Enevold, Michael Alifrangis, Juan J. Sanchez, Ilona Carneiro, Cally Roper, Claus Børsting, John Lusingu, Lasse S. Vestergaard, Martha M. Lemnge, Niels Morling, Eleanor Riley, and Chris J. Drakeley. (2007) Associations between α+-Thalassemia and Plasmodium falciparum Malarial Infection in Northeastern Tanzania. The Journal of Infectious Diseases 196:3, 451-459
Online publication date: 1-Aug-2007.
Abstract-Full Text-PDF Version (422 kB)
Clare I. R. Chandler, Chris J. Drakeley, Hugh Reyburn, Ilona Carneiro. (2006) The effect of altitude on parasite density case definitions for malaria in northeastern Tanzania. Tropical Medicine and International Health 11:8, 1178
CrossRef

  • Presented in part: Third Multilateral Initiative on Malaria Pan African Malaria Conference, Arusha, Tanzania, 17–22 November 2002 (abstract 318).

    Financial support: UK Medical Research Council (grant G9901439); Danish International Development Agency.

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