Eleven years of malaria surveillance in a Sudanese village highlights unexpected variation in individual disease susceptibility and outbreak severity

• Published in: Parasitology Vol. 129; no. 3; pp. 263 - 271
• Main Authors: CREASEY, A., GIHA, H., HAMAD, A. A., EL HASSAN, I. M., THEANDER, T. G., ARNOT, D. E.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.09.2004
• Subjects: Adolescent; Adult; Animals; Biological and medical sciences; Child; Child, Preschool; Climate; clinical incidence; Cohort Studies; Data analysis; Disease Susceptibility - parasitology; Epidemiology; Female; Fundamental and applied biological sciences. Psychology; General aspects; General aspects and techniques. Study of several systematic groups. Models; Humans; Infant; Invertebrates; longitudinal analysis; Longitudinal Studies; Malaria; Malaria, Falciparum - drug therapy; Malaria, Falciparum - epidemiology; Malaria, Falciparum - parasitology; Malaria, Falciparum - transmission; Male; Middle Aged; Parasites; Plasmodium falciparum - growth & development; Plasmodium falciparum malaria; Pregnancy; Prevalence; Rural Population; Seasons; Sudan; Sudan - epidemiology; Africa; Sudan; longitudinal analysis; clinical incidence; Plasmodium falciparum malaria; Sudan; Protozoa; Apicomplexa; Protozoal disease; Disease; Malaria; Village; Parasite; Parasitosis; Infection; Plasmodium falciparum; Outbreak; Interindividual comparison
• ISSN: 0031-1820; 1469-8161
• DOI: 10.1017/S0031182004005724

An analysis is presented of continuous data collected over 11 years based on 1902600 person/days of observation on the malaria experience of the people of Daraweesh, a village in eastern Sudan. Malaria transmission is hypo-endemic: the acquisition of clinical immunity with age is not as obvious as in more holo-endemic areas and malaria remained a problem in all age groups throughout the study. However, this population, who are of Fulani origin, showed a distinctly variable level of disease susceptibility. Thirty-two percent of the village never reported malaria symptoms or required malaria treatment while others experienced up to 8 clinical episodes over the 11 years of observation. Malaria incidence was clearly influenced by drought but much less obviously by rainfall. To what extent outbreak patterns are explicable in terms of anopheline factors, and to human immune factors, remains an interesting question for malaria modelling in this, and in other low transmission zones, such as the burgeoning urban areas of modern Africa.