The Study of Cultural and Biological Adaptations to Malaria in Nepal

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The main purpose of this project is to elucidate the differences in malaria infection between the two kinds of inhabitants in lowland Nepal : those who have been coping with malaria culturally and those who have been adapting to malaria genetically. We carried out four times of field research in September-October, 2000, March and August, 2001 and February, 2002 at a settlement of Mahadevsthan Village Development Committee in Kabhrepalanchok District in cooperation with the inhabitants.We found hereditary anemia such as alpha-thalassemia, Hemoglobin E and Glucos-6-Phosphate Dehydrogenase (G6PD) deficiency in the inhabitants. The prevalence of these kinds of anemia is very low or not found among the Tamangs, Parbate Hindus and Newars who have been coping with malaria culturally, whereas the Danuwars who have been living in malaria endemic riparian areas have a high rate of alpha thalassemia. In addition, no sample of Duffy antigen (-/-) and ovalocytosis was found.As for the difference of malaria infection, we adopted not only the examination of smear samples but also PCR diagnosis, and found that the changes of hemoglobin level among alpha- thalassemia carriers are generally smaller than those among the non carriers.Besides, we found high prevalence of filarial and helminthic infections among the inhabitants, and detected many metacercariae of liver flukes in the fishes, which were caught in nearby rivers.