Clinical and parasitological studies on malaria in Liberian adults living under intense malaria transmission.

Occurrence of fevers and chills, headaches and body and joint pains, and body temperature and malaria parasitaemias were recorded monthly for a year for 121 Liberian adults. There was no apparent correlation between any of the symptoms and the presence or density of blood parasites; it was therefore not possible to define a case of clinical malaria in the study population, which was probably highly immune to infection. Only a few people with patent blood infections had elevated blood temperatures and these were below 37.5 degrees C. Malaria prevalence and levels of parasitaemia declined with age and indicated that immunity continues to develop well into adult age. The data did not support the view that adults experience symptoms at lower parasitaemias than children. Pregnant and non-pregnant women had similar levels of symptoms, but high levels of parasitaemia were found more frequently in the pregnant group.