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  In this article
 ¤  Material and Methods
 ¤  Results
 ¤  Discussion
 ¤  Conclusions
 ¤  Summary
 ¤  Acknowledgements
 ¤  References

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ORIGINAL CONTRIBUTION
Year : 1997  |  Volume : 51  |  Issue : 3  |  Page : 89-92
 

Distribution of malarial parasites : Effect of gender of construction workers


1 Department of Community Medicine, K.M.C., Mangalore, India
2 Department of Pathology, K.M.C., Mangalore, India
3 Department of Community Medicine, K.M.C., Mangalore-575 001, Karnataka State, India

Correspondence Address:
A Rajeev
Department of Community Medicine, K.M.C., Mangalore
India
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How to cite this article:
Venugopalan P P, Shenoy D U, Kamath A, Rajeev A. Distribution of malarial parasites : Effect of gender of construction workers. Indian J Med Sci 1997;51:89-92

How to cite this URL:
Venugopalan P P, Shenoy D U, Kamath A, Rajeev A. Distribution of malarial parasites : Effect of gender of construction workers. Indian J Med Sci [serial online] 1997 [cited 2014 Sep 19];51:89-92. Available from: http://www.indianjmedsci.org/text.asp?1997/51/3/89/11526


The male predominance in des­criptive studies of malaria without population base seems to be ra­ther common. It is often attributed to the frequent exposure to vec­tors, the males are subjected to, compared to the better-clad and indoor-dwelling females in India. [1] There appears a lack of informa­tion regarding equally exposed groups of male and female cohorts to malaria. In this article we pre­sent a cross-sectional study which describes the hidden as well as overt infection in groups of mig­rant urban construction workers living in substandard tin sheds during peak transmission season of malaria in the city of Mangalore, South India.


 ¤ Material and Methods Top


A haemo-parasitological and cli­nical survey was undertaken among construction workers dur­ing the peak transmission season of malaria in Mangalore, which happens to be July to August. All major building sites holding 50 or more workers were selected for the survey. Complete coverage was ensured to the maximum ex­tent possible by fixing the date of survey to the convenience of the site supervisor and the Corpora­tion Health Office. Total coverage was 2196 including children of the workers. A proforma for the site­survey and line-listing of all the workers with details such as dura­tion of stay and clinical information was used. The survey teams con­sisted of staff and interns of the department of Community medi­cine, Kasturba Medical College and the experienced malaria surveil­lance teams from the health ser­vices augmented by Mangalore City Corporation officials. The time-tested thick and thin smear techniques were followed and the staining was done by the district malaria laboratory using JSB stain. Slides were examined for malarial parasites by the Pathology depart­ment of species identification was carried out in positive cases.

The statistical analysis was car­ried out for age sex, clinical sym­ptoms and the species concerned using X 2 test and logistic regres­sion.


 ¤ Results Top


Out of the total population of 2196 studied 1631 were males and 565 females. At the time of visit 750 (34.2%) persons complained of fever with or without chills and/ or headache and/or malaise. All symptomatic persons were put on presumptive treatment to cut trans­mission to NMEP schedule. The results of the blood examination for malarial parasites (M.P.) were as foils. The slide positivity rate was 6.28%. When taken separately, males had 5.8% and females had 7.6%. This showed an almost similar rate of infection in both the sexes (p>0.05, NS). The higher number of infection noticed among the male population appa­rently reflect the proportionate predominance of males in the study group. Among the species of plasmodia, Pm falciparum was more prevalent in females (19% vs. 13%) than males. The reasons for this finding could not be esta­blished and might require more investigations. Age-wise 15 to 45 yr. age-group was predominantly affected. Second Commonest group was 5-14 years of age.

Importance of clinical symptoms for diagnosis was assessed in both males and females. The sensiti­vity of symptoms as a pointer to diagnosis was 58.95% and 55.8% respectively. Logistic regression showed that females were 1.48 more (p<001) likely to report any symptom compared to males. The OR (Odds Ratio) for P. vivax for producing symptoms was 2.5 (p<.001) as compared to MP ne­gative cases whereas with P. fal­ciparum plus mixed cases it was 4.25 (p=.004). However, the smear positivity was only related to sym­ptoms and not to the sex of the subject. Symptomatic individuals were 2.687 times likely to have malaria than asymptomatics.


 ¤ Discussion Top


The overall prevalence of mala­rial parasites with or without sym­ptoms can be as high as about 50%> in adults of high endemic areas as Garki Project demonstrat­ed. [2] Young age groups were parti­cularly susceptible. Comparison of sexes showed high average parasite rates/parasite densities in males after the age of 5 years. This had been speculated elsewhere as due to possible influence of testo­sterone on parasitic diseases. 1048 Ghanaian children surveyed showed weighed overall means of parasitemia of lower magnitude in females, [3] but, did not show any major difference in overall para­site rates between males and fe­males. The present study also failed to demonstrate any statisti­cal difference in parasite preva­lence among females and males. Social, residential or clothing fac­tors leading to difference in expo­sure to malarial vector were much more uniform in this study group than any other population studied so far. Only difference was that she predominant species in this part of the world was P. vivax. Smear positivity was found related to the presence of symptoms Clini­cal criteria viz. fever, vomiting, splenomegaly etc. have been found useful in improving the diagnosis of malaria even in endemic areas in spite of high asymptomatic case rate. [4] Symptoms might be more suggestible of malaria if the sub­ject were a male or if the parasite were P. falciparum. The latter hypothesis needs further research proof.


 ¤ Conclusions Top


The study brings out the rising trends in malaria prevalence in migrant labourers in Mangalore. This is a relatively recent develop­ment, considering spun in building activities after 1990. The high asymptomatic reservoir of infec­tion in such unprotected groups of population helps spread the in­fection to the surrounding areas investigation into the problem re­vealed the equal prevalence rates of plasmodia in both the sexes con­trary to the belief that males are commoner preys to the infection. The study also supports the stra­tegy of mass radical treatment in such agglomerations in view of high point prevalence rates during peak season and presumptive treatment for malaria for all sym­ptomatic individuals.


 ¤ Summary Top


The city of Mangalore in South India was having increasing num­ber of malaria cases from 1990. Concerned over the import of cases through migrant construc­tion workers, a screening was done among them using clinical and parasitological methods. This demonstrated 6.28% slide positi­vity rate with statistically insignifi­cant difference in prevalence of in­fection between males and fe­males. There were many asympto­matic individuals reporting positive only on peripheral smear examina­tion. Yet, clinical symptoms like fever were found to have good pre­dictive value on logistic regression. I was more so with the P. falcipa­rum which is a relatively new en­trant to Mangalore.


 ¤ Acknowledgements Top


The authors thank the Malaria Control Action Committee of Man­galore for supporting the pro­gramme by providing vehicles and educational materials. Corpora­tion officials were very much help­ful in arranging the sites on a day­to-day basis. The health services personnel provided the much­needed expertise for collecting perpheral-smears and the district malaria laboratory for staining the smears. The interns of Kasturba Medical College provided the treatment support to the pro­gramme. Staff members of depart­ment of Pathology as well as com­munity Medicine were generous enough to oversee the whole operations. We thank them.

 
 ¤ References Top

1.Parks Textbook of Preventive and Social Medicine 13th edition. M/s Bhanarsidas Bhanot, Jabalpur. 1991:Page 172.  Back to cited text no. 1      
2.M61ineaux L, Gramiccia G. The Garki Project. WHO Geneva 1980; 122-125.  Back to cited text no. 2      
3.Barbara L, Herwig K, Gerhard W, Walther HW. Parasite density of P. falciparum in Ghanaian school children : Evidence for influence of sex hormones. Transactions of the Royal Society of Tropical Medi­cine and Hygiene 1994:88:73-74.  Back to cited text no. 3      
4.Genton B, Smith T, Baea K, Narara A. et al. Malaria : Howuseful are clinical criteria for improving the diagnosis in a highly endemic area. Transactions of the Royal Society of Tropical Medicine and Hygiene 1994:88:537-541.  Back to cited text no. 4      



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