Epidemiology and Infection
Volume 131, Issue 1, 2003, Pages 791-797

Adult Javanese migrants to Indonesian Papua at high risk of severe disease caused by malaria (Article)

Baird J.K.* , Basri H. , Weina P. , Maguire J.D. , Barcus M.J. , Picarema H. , Elyazar I.R.F. , Ayomi E. , Sekartuti A.
  • a U.S. Naval Medical Research Unit #2, American Embassy, Parasitic Diseases Program, Jakarta, Indonesia
  • b U.S. Naval Medical Research Unit #2, American Embassy, Parasitic Diseases Program, Jakarta, Indonesia
  • c Walter Reed Army Medical Center, Washington, DC, United States
  • d U.S. Naval Medical Research Unit #2, American Embassy, Parasitic Diseases Program, Jakarta, Indonesia
  • e U.S. Naval Medical Research Unit #2, American Embassy, Parasitic Diseases Program, Jakarta, Indonesia
  • f U.S. Naval Medical Research Unit #2, Satellite Laboratory, Jayapura, Papua, Indonesia
  • g U.S. Naval Medical Research Unit #2, American Embassy, Parasitic Diseases Program, Jakarta, Indonesia
  • h Provincial Health Services, Jayapura, Papua, Indonesia
  • i National Health Research Center, Jakarta, Indonesia

Abstract

Migrants from Java arrive in hyperendemic Papua, Indonesia lacking exposure to endemic malaria. We evaluated records of evacuation to hospital with a diagnosis of severe malaria from a transmigration village in northeastern Papua. During the first 30 months, 198 residents with severe disease were evacuated (7.5 evacuations/100 person-years). During this period the risk of evacuation for adults (> 15 years of age) was 2.8. (95% CI = 2.1-3.8; P < 0.0001) relative to children, despite apparently equal exposure to risk of infection. Relative risk (RR) for adults was greatest during the first 6 months (RR > 16; 95% CI ≥ 2.0-129; P = 0.0009), and diminished during the second 6 months (RR = 9.4; 95% CI = 2.7-32.8; P < 0.0001) and the third 6 months (RR = 3.7; 95% CI = 1.7-7.9; P = 0.0004). During the next two 6-month intervals, the RR for adults was 1.6 and 1.5 (95% CI range 0.8-2.6; P < 0.18). Adults lacking chronic exposure were far more likely to progress to severe disease compared to children during initial exposure, but not after chronic exposure to infection.

Author Keywords

[No Keywords available]

Index Keywords

hospitalization human Cohort Studies middle aged controlled study Malaria Aged Humans Adolescent Severity of Illness Index Infant, Newborn male female Infant Child, Preschool Risk Factors medical record Indonesia diagnostic test high risk population Incidence Article Papua New Guinea Retrospective Studies major clinical study adult migration infection risk Age Factors endemic disease Plasmodium falciparum population exposure Emigration and Immigration Disease Progression disease severity Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-0042641573&doi=10.1017%2fS0950268803008422&partnerID=40&md5=56f46adc7c7c6f398505db2b0cb5b394
DOI: 10.1017/S0950268803008422
ISSN: 09502688
Cited by: 18
Original Language: English