Vecteurs et facteurs d'environnement du paludisme

Abstract

Malaria is a major risk for more than two billion human beings on Earth, and is the cause of 700,000 to 2.5 million deaths per year. The causative factor, Plasmodium (four species), involves an asexual cycle in man and a sexual one in anopheline mosquitoes. The four species of Plasmodium are pathogenic for man but P. falciparum accounts for more than 90% of deaths. Only black Africans are refractory to P. vivax, a characteristic linked to the lack of Duffy antigen. Among the 400 species of anophelines so far recorded, less than 50 are recognized malaria vectors. Every one has its own geographic and ecological characteristics, which locally induce the epidemiological trends and its biodiversity. In a given site transmission depends on competent anopheline species, their infective rate and their biting rate. Inhabitants of endemic areas develop during infancy immunity which protect them during the rest of their lives. This immunity (premunition) between parasite and its host is acquired at an heavy price of infant mortality. It can decrease rapidly when people leave endemic areas. Because inhabitants of endemic areas continue to harbor asymptomatic parasites they become good parasite reservoirs. The diversity of epidemiological situations needs a diversification of malaria control measures. The prognosis of the evolution of malaria depends on control measures, applied or not, and on the evolution of climatic and anthropic environment, which are very hard to predict for the time being.