Risk factors for Plasmodium falciparum hyperparasitaemia in malarious children

BMC Infectious Diseases

Research Article

Akintunde Sowunmi¹  Titilope M Okuboyejo¹  Grace O Gbotosho¹  Christian T Happi¹ 

[1]Department of Pharmacology & Therapeutics and Institute for Medical Research and Training, University of Ibadan, Ibadan, Nigeria

关键词: Hyperparasitaemia;    children;    risk factors;    Nigeria;   

DOI  :  10.1186/1471-2334-11-268

 received in 2011-03-15, accepted in 2011-10-09,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundHyperparasitaemia is a feature of childhood severe malaria but there is little information on the risk factors for hyperparasitaemia in malarious childrenMethodsThe risk factors associated with Plasmodium falciparum hyperparasitaemia, defined as asexual parasitaemia > 250,000/μl, at presentation were evaluated in 3338 malarious children enrolled prospectively between 2008 and 2010 in an endemic area of southwestern Nigeria.ResultsAt enrolment, 97 (3%) of 3338 malarious children had hyperparasitaemia. In a multiple regression model, 3 factors were found to be independent risk factors for the presence of hyperparasitaemia at enrolment: an age ≤ 11 years (Adjusted odds ratio [AOR] = 2.85, 95% confidence interval [CI] 1.23-6.61, P = 0.014), fever (AOR = 2.02, 95% CI 1.23-3.29, P = 0.005), and enrolment after year 2008 (AOR = 0.42, 95% CI 0.24-0.73, P = 0.002). Duration of illness ≤ 3 d was associated with increased risk of hyperparasitaemia. There was no association between season and hyperparasitaemia. Compared to non-hyperparasitaemia, hyperparasitaemia was associated with an increased risk of progression to cerebral malaria (P < 0.0001). The risk of progression in hyperparasitaemic children was higher in < 5-year olds (P = 0.02).ConclusionYoung age and presence of fever are independent risk factors for hyperparasitaemia which is associated with an increased risk of progression to cerebral malaria. The findings have implications for case and community management of childhood hyperparasitaemia and for malaria control efforts in sub-Saharan Africa where severe malaria is relatively common.

【 授权许可】

CC BY   
© Sowunmi et al; licensee BioMed Central Ltd. 2011