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

Published online by Cambridge University Press:  23 September 2003

J. K. BAIRD ,
H. BASRI ,
P. WEINA ,
J. D. MAGUIRE ,
M. J. BARCUS ,
H. PICAREMA ,
I. R. F. ELYAZAR ,
E. AYOMI  and
SEKARTUTI
J. K. BAIRD
Affiliation:
U.S. Naval Medical Research Unit #2, Jakarta, Indonesia
H. BASRI
Affiliation:
U.S. Naval Medical Research Unit #2, Jakarta, Indonesia
P. WEINA
Affiliation:
Walter Reed Army Medical Center, Washington, DC
J. D. MAGUIRE
Affiliation:
U.S. Naval Medical Research Unit #2, Jakarta, Indonesia
M. J. BARCUS
Affiliation:
U.S. Naval Medical Research Unit #2, Jakarta, Indonesia
H. PICAREMA
Affiliation:
U.S. Naval Medical Research Unit #2 Satellite Laboratory, Jayapura, Papua, Indonesia
I. R. F. ELYAZAR
Affiliation:
U.S. Naval Medical Research Unit #2, Jakarta, Indonesia
E. AYOMI
Affiliation:
Provincial Health Services, Jayapura, Papua, Indonesia
SEKARTUTI
Affiliation:
National Health Research Center, Ministry of Health, Jakarta, Indonesia
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Abstract

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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[ges ]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.

Type
Research Article
Information
Epidemiology & Infection , Volume 131 , Issue 1 , August 2003 , pp. 791 - 797
Copyright
© 2003 Cambridge University Press