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dc.contributor.authorBuchwald, A.G.
dc.contributor.authorSorkin, J.D.
dc.contributor.authorSixpence, A.
dc.date.accessioned2019-03-29T14:47:35Z
dc.date.available2019-03-29T14:47:35Z
dc.date.issued2019
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85058882414&doi=10.1093%2faje%2fkwy213&partnerID=40&md5=8a2f2990afb1f345a8b30b147be9bb9c
dc.identifier.urihttp://hdl.handle.net/10713/8668
dc.description.abstractFew 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.en_US
dc.description.urihttps://dx.doi.org/10.1093/aje/kwy213en_US
dc.language.isoen_USen_US
dc.publisherOxford Academicen_US
dc.relation.ispartofAmerican journal of epidemiology
dc.subject.meshMalaria, Falciparum--epidemiologyen_US
dc.subject.meshPlasmodium falciparumen_US
dc.titleAssociation Between Age and Plasmodium falciparum Infection Dynamicsen_US
dc.typeArticleen_US
dc.identifier.doi10.1093/aje/kwy213
dc.identifier.pmid30252032


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