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| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | Kamau, Alice Paton, Robert S. Akech, Samuel Mpimbaza, Arthur Khazenzi, Cynthia Ogero, Morris Mumo, Eda Alegana, Victor A. Agweyu, Ambrose Mturi, Neema Mohammed, Shebe Bigogo, Godfrey Audi, Allan Kapisi, James Sserwanga, Asadu Namuganga, Jane F. Kariuki, Simon Otieno, Nancy A. Nyawanda, Bryan O. Olotu, Ally Salim, Nahya Athuman, Thabit Abdulla, Salim Mohamed, Amina F. Mtove, George Reyburn, Hugh Gupta, Sunetra Lourenço, José Bejon, Philip Snow, Robert W. |
| Abstract | Background Understanding the age patterns of disease is necessary to target interventions to maximise cost-effective impact. New malaria chemoprevention and vaccine initiatives target young children attending routine immunisation services. Here we explore the relationships between age and severity of malaria hospitalisation versus malaria transmission intensity. Methods Clinical data from 21 surveillance hospitals in East Africa were reviewed. Malaria admissions aged 1 month to 14 years from discrete administrative areas since 2006 were identified. Each site-time period was matched to a model estimated community-based age-corrected parasite prevalence to provide predictions of prevalence in childhood (PfPR2–10). Admission with all-cause malaria, severe malaria anaemia (SMA), respiratory distress (RD) and cerebral malaria (CM) were analysed as means and predicted probabilities from Bayesian generalised mixed models. Results 52,684 malaria admissions aged 1 month to 14 years were described at 21 hospitals from 49 site-time locations where PfPR2–10 varied from < 1 to 48.7%. Twelve site-time periods were described as low transmission (PfPR2–10 < 5%), five low-moderate transmission (PfPR2–10 5–9%), 20 moderate transmission (PfPR2–10 10–29%) and 12 high transmission (PfPR2–10 ≥ 30%). The majority of malaria admissions were below 5 years of age (69–85%) and rare among children aged 10–14 years (0.7–5.4%) across all transmission settings. The mean age of all-cause malaria hospitalisation was 49.5 months (95% CI 45.1, 55.4) under low transmission compared with 34.1 months (95% CI 30.4, 38.3) at high transmission, with similar trends for each severe malaria phenotype. CM presented among older children at a mean of 48.7 months compared with 39.0 months and 33.7 months for SMA and RD, respectively. In moderate and high transmission settings, 34% and 42% of the children were aged between 2 and 23 months and so within the age range targeted by chemoprevention or vaccines. Conclusions Targeting chemoprevention or vaccination programmes to areas where community-based parasite prevalence is ≥10% is likely to match the age ranges covered by interventions (e.g. intermittent presumptive treatment in infancy to children aged 2–23 months and current vaccine age eligibility and duration of efficacy) and the age ranges of highest disease burden. |
| Related Links | https://bmcmedicine.biomedcentral.com/counter/pdf/10.1186/s12916-021-02224-w.pdf |
| Ending Page | 12 |
| Page Count | 12 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| ISSN | 17417015 |
| DOI | 10.1186/s12916-021-02224-w |
| Journal | BMC Medicine |
| Issue Number | 1 |
| Volume Number | 20 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2022-01-27 |
| Access Restriction | Open |
| Subject Keyword | Medicine Public Health Biomedicine Malaria Age pattern Parasite prevalence Severe malaria Anaemia Cerebral malaria Medicine/Public Health |
| Content Type | Text |
| Resource Type | Article |
| Subject | Medicine |
| Journal Impact Factor | 7.1/2023 |
| 5-Year Journal Impact Factor | 8.8/2023 |
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