MALARIA INFECTION SEVERITY AND MORTALITY ACCORDING TO GEOGRAPHICAL AND HUMAN ENVIRONMENTAL-FACTORS

Clinical aspects and malarial infection severity are linked to Plasmod ial strains, parasite load, and immune response of the infected subjec ts. The environment influences the conditions of contamination and the level of specific susceptibility. Environmental factors such as bioge ography govern epidemiological patterns of malaria which call be modif ied by local conditions such as landscape, climate changes, natural di sasters, and, most important, human-related activities such as urbaniz ation, deforestation, migration of workers or refugees, Malaria severi ty is also related to the socio-economic level of infected populations and endemic countries as shown by border countries with different gro ss national product per inhabitant (i.e. Congo versus Zaire, Brazilian states of Amazon versus French Guyana, Comore Island versus Mayotte.. .). In non endemic countries with an equivalent socio-economical level , severity of imported malaria is related to the status of travellers, to the tropical destination, and to competency of local physicians.