Transmission and Age Impact the Risk of Developing Febrile Malaria in Children with Asymptomatic Plasmodium falciparum Parasitemia.

Autor:	Wamae K; Kenya Medical Research Institute Wellcome Trust Research Programme, Kilifi, Kenya., Wambua J; Kenya Medical Research Institute Wellcome Trust Research Programme, Kilifi, Kenya., Nyangweso G; Kenya Medical Research Institute Wellcome Trust Research Programme, Kilifi, Kenya., Mwambingu G; Kenya Medical Research Institute Wellcome Trust Research Programme, Kilifi, Kenya., Osier F; Kenya Medical Research Institute Wellcome Trust Research Programme, Kilifi, Kenya., Ndung'u F; Kenya Medical Research Institute Wellcome Trust Research Programme, Kilifi, Kenya.; Nuffield Department of Medicine, Centre for Clinical Vaccinology and Tropical Medicine, Churchill Hospital, University of Oxford, United Kingdom., Bejon P; Kenya Medical Research Institute Wellcome Trust Research Programme, Kilifi, Kenya.; Nuffield Department of Medicine, Centre for Clinical Vaccinology and Tropical Medicine, Churchill Hospital, University of Oxford, United Kingdom., Ochola-Oyier LI; Kenya Medical Research Institute Wellcome Trust Research Programme, Kilifi, Kenya.; Centre for Biotechnology and Bioinformatics, University of Nairobi, Kenya.
Jazyk:	angličtina
Zdroj:	The Journal of infectious diseases [J Infect Dis] 2019 Feb 23; Vol. 219 (6), pp. 936-944.
DOI:	10.1093/infdis/jiy591
Abstrakt:	Background: Plasmodium falciparum infections lead to febrile illness unless the host has sufficient immunity, in which case infection may cause no immediate symptoms (ie, "asymptomatic parasitemia"). Previous studies are conflicting on the role of asymptomatic parasitemia in determining the risk of developing febrile malaria. Methods: We monitored 2513 children (living in Kilifi, Kenyan Coast) by blood smears in 17 cross-sectional surveys to identify asymptomatic parasitemia and used active surveillance over 11325 child-years of follow-up to detect febrile malaria. We evaluated the interaction between transmission intensity, age, and asymptomatic parasitemia in determining the risk of developing febrile malaria. Results: In the moderate and high transmission intensity settings, asymptomatic parasitemia was associated with a reduced risk of febrile malaria in older children (> 3 years), while in the lower transmission setting, asymptomatic parasitemia was associated with an increased risk of febrile malaria in children of all ages. Additionally, the risk associated with asymptomatic parasitemia was limited to the first 90 days of follow-up. Conclusions: Asymptomatic parasitemia is modified by transmission intensity and age, altering the risk of developing febrile episodes and suggesting that host immunity plays a prominent role in mediating this process. (© The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu