4.8 Article

Malaria infection and severe disease risks in Africa

期刊

SCIENCE
卷 373, 期 6557, 页码 926-+

出版社

AMER ASSOC ADVANCEMENT SCIENCE
DOI: 10.1126/science.abj0089

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资金

  1. Wellcome Trust [212176/Z/18/Z, 097170, 207522, 092654]
  2. FCDO/MRC/NIHR/Wellcome Trust Joint Global Health Trials Scheme [MR/R006083/1]
  3. CDC Foundation, through World Health Organization [2018/854999]
  4. Wellcome Trust since 2006 under the Core Award for the East Africa Major Overseas Programme [092654, 077092, 203077/Z/16/Z]
  5. President's Malaria Initiative, U.S. Agency for International Development
  6. Centers for Disease Control and Prevention [1U51CK000117, 5NU2GGH001744-0200]
  7. European Commission (Europaid) [SANTE/2004/078-607]
  8. DELTAS Africa Initiative [DEL-15-003]
  9. New Partnership for Africa's Development Planning and Coordinating Agency
  10. UK government
  11. Department of Zoology, University of Oxford
  12. Wellcome Trust [212176/Z/18/Z] Funding Source: Wellcome Trust

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This study shows a positive correlation between malaria parasite prevalence and severe malaria admission rates, with severe malaria predominantly affecting children aged 3 to 59 months in the diverse community prevalence typical of East Africa. It offers a quantitative framework for linking malaria parasite prevalence and severe disease outcomes in children.
The relationship between community prevalence of Plasmodium falciparum and the burden of severe, life-threatening disease remains poorly defined. To examine the three most common severe malaria phenotypes from catchment populations across East Africa, we assembled a dataset of 6506 hospital admissions for malaria in children aged 3 months to 9 years from 2006 to 2020. Admissions were paired with data from community parasite infection surveys. A Bayesian procedure was used to calibrate uncertainties in exposure (parasite prevalence) and outcomes (severe malaria phenotypes). Each 25% increase in prevalence conferred a doubling of severe malaria admission rates. Severe malaria remains a burden predominantly among young children (3 to 59 months) across a wide range of community prevalence typical of East Africa. This study offers a quantitative framework for linking malaria parasite prevalence and severe disease outcomes in children.

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