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    School-age Children Are a Reservoir of Malaria Infection in Malawi

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    Author
    Walldorf, Jenny Anne
    Advisor
    Laufer, Miriam K.
    Date
    2015
    Type
    dissertation
    
    Metadata
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    Abstract
    Background: Malaria surveillance and interventions in endemic countries often target young children at highest risk of malaria morbidity and mortality. School-age children and adults not captured in surveillance may contribute to malaria transmission. Methods: Cross-sectional surveys were conducted in one rainy and one dry season in southern Malawi. Demographic and health information was collected for all household members. Blood samples were obtained from individuals aged greater than six months for microscopic and PCR identification of Plasmodium falciparum. Results: Specimens were collected from 5,796 individuals. PCR prevalence of malaria infection was 5%, 10%, and 20% in dry, and 9%, 15%, and 32% in rainy seasons in Blantyre, Thyolo, and Chikhwawa, respectively. Over 88% of those infected were asymptomatic. Participants aged 6-15 years were at higher risk of infection (OR = 4.8; 95% CI, 4.0-5.8) and asymptomatic infection (OR = 4.2; 95% CI, 2.7-6.6) than younger children in all settings. School-age children used bednets less frequently than other age groups. Compared to young children, school-age children were brought less often for treatment and more often to unreliable treatment sources. Conclusions: School-age children represent an underappreciated reservoir of malaria infection and have limited exposure to antimalarial interventions. Malaria control and elimination strategies may need to expand to include this age group.
    Description
    University of Maryland, Baltimore. Epidemiology and Preventive Medicine. M.S. 2015
    Keyword
    bednets
    malaria surveillance
    school-age children
    Asymptomatic Infections
    Cross-Sectional Studies
    Malaria, Falciparum
    Mosquito Nets
    Plasmodium falciparum
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/4624
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    Theses and Dissertations School of Medicine
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