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Pages 200-249 200 Preto, São José do Rio Preto - SP, Brazil, 5Universidade Federal do Acre, Rio level factor associated with malaria risk; linear age splines revealed Branco - AC, Brazil that malaria risk was highest at age 9. Only one household level factor, The objective of this study was to characterize socio-economic, number of adults in household with indoor job [IRR=0.54, 95% CI=(0.34, demographic, environmental, genetic and immunological risk factors for 0.88)], was associated with malaria risk in children. In conclusion, several acquiring malaria in a rural setting in the Brazilian Amazon (Granada, individual and household level factors that account for malaria clustering Acrelândia, AC). A prospective cohort of 466 subjects (113 families) aged were identified. These factors should be considered when developing between <1 and 90 y.o. was started in March 2004 in the Granada area malaria interventions for highland urban communities in Africa. with a baseline visit to collect information about personal and family history was selected. Blood samples were taken from subjects > 5 y.o. 699 for parasitological, immunological and genetic studies. The cohort was MULTILEVEL ANALYSIS OF SOCIAL, ECOLOGICAL, AND followed daily for malaria episodes between March 2004 - May 2005. All families were visited again in Set/2004 and Feb/2005 to update personal BIOLOGICAL PREDICTORS OF POLYPARASITISM IN COASTAL information and search for asymptomatic infected subjects. 65 (13.9%) KENYA lost subjects were censored in the analysis. There were 195 episodes of Lia S. Florey, Melissa K. Van Dyke1, Charles H. King2, Eric M. malaria (48 by Plasmodium falciparum, 114 by P. vivax, and 33 mixed Muchiri3, Peter L. Mungai4, Peter A. Zimmerman2, Mark L. Wilson1 infections) in 122 subjects (42.27 episodes/100 person-years). Malaria 1University of Michigan, Ann Arbor, MI, United States, 2Case Western incidence was similar in males and females (44.25 and 40.12 episodes/100 Reserve University, Cleveland, OH, United States, 3Division of Vector Borne person-years respectively, P=0.4822). Subjects <1 year old had the highest Diseases, Ministry of Health, Nairobi, Kenya, 4Msambweni Field Station, incidence of vivax malaria (56.14 episodes/100 person-years, P=0.0035), Msambweni, Kenya while falciparum malaria incidence was higher in subjects 5 -14 years old and in those >30 y.o (20.1 and 18.4 episodes/100 person-years Schistosomiasis and malaria are diseases with complex etiologies in which respectively), although not achieving statistical significance. Preliminary social, ecologic and biologic factors interact to cause pathology. Although univariate analysis of putative risk factors (demographic, socio-economic, both diseases share some common risk factors, few studies have examined environmental, behavioral, FcγRIIa allotype, Duffy promoter type and the relative importance of these factors in predicting co-infection. We previous exposure to malaria) showed that age, place of residence, wealth applied multilevel analyses to investigate the relative importance of index, previous exposure to malaria and Fcγ receptor IIA genotype were individual-level behavioral and biological factors and household-level significantly associated to the relative risk of presenting an episode of social and environmental factors in prediction of co-infection. Specifically, clinical malaria of any type during follow-up (P 0.0197 to < 0.0001), we studied the contextual determinants of Schistosoma and Plasmodium while land-clearing activities, fishing and bednet use were associated infection in southeastern coastal Kenya. Following informed consent, with a higher RR of presenting falciparum malaria episodes(P 0.0304 to 1,300 residents of Kingwede village (Kwale District) aged 8 years and < 0.0001). Detection of antibodies a-PvMSP-1 and multivariate analysis older participated during April and May, 2006. Presence and intensity are in progress. In conclusion, rural settlements are currently an important of S. haematobium infection was determined using standard urine keypiece of malaria transmission in the Amazon, and this study shows filtration examination. Presence and intensity of Plasmodium infection that such longitudinal studies are feasible. Our results indicate association was determined using standard thick and thin blood slide examination as of individual characteristics and environmental variables to symptomatic well as by PCR. Participants were administered a detailed questionnaire in malaria infection, with some differences between P. vivax and P. falciparum Kiswahili addressing schistosomiasis and malaria knowledge, self-reported transmission. water use and other health practices, and socioeconomic status (SES). SES scales were developed for individuals and for households based on 698 previous research. Results showed a significantly higher prevalence of co- infection (15.5%, OR = 2.07 (1.5-2.86) than would be expected based INDIVIDUAL AND HOUSEHOLD LEVEL FACTORS ASSOCIATED on single infection prevalences (23.5% for S. haematobium and 52.2% WITH MALARIA INCIDENCE IN NAZARETH, ETHIOPIA for Plasmodium spp.), indicating potential shared risk factors for the two diseases. We used general estimating equations (GEE) models to evaluate 2 Ingrid Peterson , Awash Teklehaimanot individual age, sex, education and health behaviors, as well as household 1New York University - Medical Parasitology, New York, NY, United States, SES, household practices, and household environmental variables (distance 2Columbia University - Department of Epidemiology, New York, NY, United to water bodies, housing quality) as predictors of co-infection. Household States factors contributed significantly to prediction of S. haematobium and Malaria risk has been shown to vary greatly between households Plasmodium spp. co-infection, suggesting that household-focused within communities (1), as well as between individuals within the same interventions such as latrine construction or improving housing quality household (2). To develop effective malaria interventions, it is useful may be more effective in disease prevention than current individual-based to identify individual and household level risk factors that underlie this methods. variation in risk. Multilevel analysis of cohort data was used to identify individual and household level factors associated with malaria risk in 700 1,367 individuals in a peri-urban area of highland Ethiopia. Data were also used to estimate the proportion of between-household variance in INTEGRATING ONE OF THE NTDS WITH ONE OF THE BIG malaria incidence attributable to explanatory factors. In both adults and THREE. AN INTEGRATED MALARIA INDICATOR, PARASITE children, living within 350 meters of the major vector-breeding site greatly PREVALENCE, TRACHOMA INDICATOR, AND TRACHOMA increased malaria risk and was the most influential factor determining PREVALENCE SURVEY IN AMHARA REGIONAL STATE, between household variance in malaria incidence, accounting for 38.78% ETHIOPIA and 78.49% of this variance in adults and children respectively. In Paul Emerson, Yeshewamebrat Ejigsemahu2, Estifanos Biru2, adults, individual level factors associated with malaria risk were regular Patricia Graves1, Jeremiah Ngondi1, Asrat Genet3, Teshome Gebre2, or recent travel to rural areas [IRR=12.96, 95% CI=(4.05, 41.48)], and Tekola Endeshaw2, Aryc Mosher1, Frank Richards1 having an indoor job [IRR=0.37, 95% CI= (0.16,0.87)]. Household level 1 2 factors associated with malaria risk in adults were low vegetation level in The Carter Center, Atlanta, GA, United States, The Carter Center, Addis 3 compound [IRR=0.27, 95% CI= (0.10, 0.78)], tidy compound [IRR=0.29, Ababa, Ethiopia, Amhara Regional Health Bureau, Bahir Dar, Ethiopia 95% CI=(0.12, 0.71)], household use of preventive measures [IRR=0.31, Trachoma prevalence in Amhara regional state of Ethiopia is believed to be 95% CI=(0.13, 0.74)] and the number of 5 to 9 year olds in household one of the highest in the world; the region is also subject to unstable and [IRR=1.66, 95% CI=(1.08, 2.53)]. In children, age was the only individual epidemic malaria. The Carter Center is conducting an integrated malaria www.astmh.org 20 and trachoma control program implementing the full SAFE strategy for species are associated with a wide spectrum of disease severity and control and supporting an integrated malaria control program through the considerable morbidity, mortality and healthcare expenditure particular in distribution of long lasting insecticidal nets (LLIN). To provide baseline data, young children. The spectrum of severe disease associated with Pf and Pv a large (160 cluster) household survey was conducted during December infections will be presented and further discussed. 2006 (towards the end of the peak malaria season) to estimate malaria indicators, particularly net coverage, malaria parasite prevalence, trachoma 702 risk factors, and prevalence of clinical trachoma signs in all ages in each of the ten zones of Amhara national regional state. A total of 160 clusters BLOOD GROUP O PROTECTS AGAINST SEVERE of at least 25 households (total households=4122) were surveyed for PLASMODIUM FALCIPARUM MALARIA net coverage and all persons living in these households (N=19,234) were J. Alexandra Rowe, Anne-Marie Deans examined for trachoma signs. All individuals in even numbered households were tested for malaria parasites by microscopy (N=7,751). Preliminary Institute of Immunology and Infection Research, Unversity of Edinburgh, analysis showed that the overall prevalence of trachomatous
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