Relation between severe malaria morbidity in children and level of Plasmodium falciparum transmission in Africa

Lancet
R W SnowK Marsh

Abstract

Malaria remains a major cause of mortality and morbidity in Africa. Many approaches to malaria control involve reducing the chances of infection but little is known of the relations between parasite exposure and the development of effective clinical immunity so the long-term effect of such approaches to control on the pattern and frequency of malaria cannot be predicted. We have prospectively recorded paediatric admissions with severe malaria over three to five years from five discrete communities in The Gambia and Kenya. Demographic analysis of the communities exposed to disease risk allowed the estimation of age-specific rates for severe malaria. Within each community the exposure to Plasmodium falciparum infection was determined through repeated parasitological and serological surveys among children and infants. We used acute respiratory-tract infections (ARI) as a comparison. 3556 malaria admissions were recorded for the five sites. Marked differences were observed in age, clinical spectrum and rates of severe malaria between the five sites. Paradoxically, the risks of severe disease in childhood were lowest among populations with the highest transmission intensities, and the highest disease risks were observed among popula...Continue Reading

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Citations

Jan 30, 2004·Trends in Parasitology·Lars Hviid, Trine Staalsoe
Sep 5, 2013·Trends in Parasitology·Erin M StuckeyNakul Chitnis
Nov 12, 2013·Trends in Parasitology·Aubrey J CunningtonMichael Walther
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Mar 23, 2006·Transactions of the Royal Society of Tropical Medicine and Hygiene·Terrie TaylorDavid Wypij
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Sep 1, 2009·Transactions of the Royal Society of Tropical Medicine and Hygiene·S YamamotoR Sauerborn
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