The age patterns of severe malaria syndromes in sub-Saharan Africa across a range of transmission intensities and seasonality settings

Malaria Journal

Research

Brian Greenwood¹  David Schellenberg¹  Ilona Carneiro¹  Joanna RM Armstrong Schellenberg¹  Arantxa Roca-Feltrer¹  Lucy Smith¹ 

[1] Department of Disease Control, Faculty of Infectious & Tropical Disease, London School of Hygiene & Tropical Medicine, Keppel Street, WC1E 7HT, London, UK;

关键词: Malaria;    Severe Malaria;    Cerebral Malaria;    Transmission Intensity;    Entomological Inoculation Rate;   

DOI  :  10.1186/1475-2875-9-282

 received in 2010-08-04, accepted in 2010-10-13,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundA greater understanding of the relationship between transmission intensity, seasonality and the age-pattern of malaria is needed to guide appropriate targeting of malaria interventions in different epidemiological settings.MethodsA systematic literature review identified studies which reported the age of paediatric hospital admissions with cerebral malaria (CM), severe malarial anaemia (SMA), or respiratory distress (RD). Study sites were categorized into a 3 × 2 matrix of Plasmodium falciparum transmission intensity and seasonality. Probability distributions were fitted by maximum likelihood methods, and best fitting models were used to estimate median ages and to represent graphically the age-pattern of each outcome for each transmission category in the matrix.ResultsA shift in the burden of CM towards younger age groups was seen with increasing intensity of transmission, but this was not the case for SMA or RD. Sites with 'no marked seasonality' showed more evidence of skewed age-patterns compared to areas of 'marked seasonality' for all three severe malaria syndromes.ConclusionsAlthough the peak age of CM will increase as transmission intensity decreases in Africa, more than 75% of all paediatric hospital admissions of severe malaria are likely to remain in under five year olds in most epidemiological settings.

【 授权许可】

CC BY   
© Roca-Feltrer et al; licensee BioMed Central Ltd. 2010