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

Authors

J. Kevin Baird, U.S. Naval Medical Research Unit #2, Jakarta, IndonesiaFollow
H. Basri, U.S. Naval Medical Research Unit #2, Jakarta, Indonesia
P. Weina, Walter Reed Army Medical Center, Washington, DC
J. D. Maguire, U.S. Naval Medical Research Unit #2, Jakarta, IndonesiaFollow
M. J. Barcus, U.S. Naval Medical Research Unit #2, Jakarta, Indonesia
H. Picarema, U.S. Naval Medical Research Unit #2 Satellite Laboratory, Jayapura, Papua, Indonesia
I. R.F. Elyazar, U.S. Naval Medical Research Unit #2, Jakarta, IndonesiaFollow
E. Ayomi, Provincial Health Services, Jayapura, Papua, Indonesia
National Health Research Center, Ministry of Health, Jakarta, Indonesia, National Health Research Center, Ministry of Health, Jakarta, Indonesia

Date of this Version

2003

Citation

Epidemiol. Infect. (2003), 131, 791–797.

Comments

U.S. Government Work

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.