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    Association Between Age and Plasmodium falciparum Infection Dynamics

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    Author
    Buchwald, A.G.
    Sorkin, J.D.
    Sixpence, A.
    Date
    2019
    Journal
    American journal of epidemiology
    Publisher
    Oxford Academic
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://dx.doi.org/10.1093/aje/kwy213
    Abstract
    Few data exist on the incidence or duration of natural Plasmodium falciparum infections in high-transmission settings. School-aged children (SAC) carry a disproportionate burden of infections, suggesting either increased incidence or increased duration. We estimated the incidence and duration of unique infections according to age groups. The Mfera Cohort Study (2014-2017) in Malawi had 2 years of follow-up, with 120 participants tested monthly and during sick visits. Blood samples were collected to detect P. falciparum by microscopy and polymerase chain reaction. Positive samples underwent genotyping. Simulation was used to account for high rates of nondetection of infection among low-parasitemia infections, which increase in frequency with age. Adults had significantly fewer unique infections per person per year (median, 2.5) compared with SAC and children younger than 5 years of age (6.3 and 6.6, respectively). Over half of all genotypes were persistent. Infections lasted significantly longer in adults (median, 180 days) and SAC (median, 163 days) compared with children younger than 5 years of age (median, 97 days), after accounting for age-dependent nondetection of infection. SAC acquired new infections at the same rate as children younger than 5 years, but they maintained these infections for longer periods of time, similar to adults. This study provides new insights into P. falciparum infection dynamics that should be considered when designing malaria control strategies.
    Keyword
    Malaria, Falciparum--epidemiology
    Plasmodium falciparum
    Identifier to cite or link to this item
    https://www.scopus.com/inward/record.uri?eid=2-s2.0-85058882414&doi=10.1093%2faje%2fkwy213&partnerID=40&md5=8a2f2990afb1f345a8b30b147be9bb9c; http://hdl.handle.net/10713/8668
    ae974a485f413a2113503eed53cd6c53
    10.1093/aje/kwy213
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