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. 2010 Oct 13:9:282.
doi: 10.1186/1475-2875-9-282.

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

Arantxa Roca-Feltrer  1 , Ilona Carneiro, Lucy Smith, Joanna Rm Armstrong Schellenberg, Brian Greenwood, David Schellenberg
Affiliations

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

Arantxa Roca-Feltrer et al. Malar J. .

Abstract

Background: A 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.

Methods: A 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.

Results: A 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.

Conclusions: Although 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.

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Figures

Figure 1
Figure 1
Age-patterns of cerebral malaria in Sub-Saharan Africa. Percentage of cerebral malaria admissions per month of age in children under ten years of age, by transmission intensity (TI) and seasonality of malaria transmission.
Figure 2
Figure 2
Age-patterns of severe malarial anaemia in Sub-Saharan Africa. Percentage of severe malarial anaemia admissions per month of age in children under 10 years of age, by transmission intensity (TI) and seasonality of malaria transmission.
Figure 3
Figure 3
Age-patterns of respiratory distress in Sub-Saharan Africa. Percentage of respiratory distress admissions per month of age in children under 10 years of age, by transmission intensity (TI) and seasonality of malaria transmission.
Figure 4
Figure 4
Age-patterns of cerebral malaria, severe malarial anaemia, and respiratory distress in Sub-Saharan Africa. Percentage of cerebral malaria, severe malarial anaemia, and respiratory distress admissions per month of age in children under 10 years of age, for each cell of the transmission intensity-seasonality matrix.
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References

    1. Marsh K, Forster D, Waruiru C, Mwangi I, Winstanley M, Marsh V, Newton C, Winstanley P, Warn P, Peshu N, Pasvol G, Snow R. Indicators of life-threatening malaria in African children. N Engl J Med. 1995;332:1399–1404. doi: 10.1056/NEJM199505253322102. - DOI - PubMed
    1. Snow RW, Bastos de Azevedo I, Lowe BS, Kabiru EW, Nevill CG, Mwankusye S, Kassiga G, Marsh K, Teuscher T. Severe childhood malaria in two areas of markedly different falciparum transmission in east Africa. Acta Trop. 1994;57:289–300. doi: 10.1016/0001-706X(94)90074-4. - DOI - PubMed
    1. Imbert P, Sartelet I, Rogier C, Ka S, Baujat G, Candito D. Severe malaria among children in a low seasonal transmission area, Dakar, Senegal: influence of age on clinical presentation. Trans R Soc Trop Med Hyg. 1997;91:22–24. doi: 10.1016/S0035-9203(97)90380-1. - DOI - PubMed
    1. Modiano D, Sirima BS, Sawadogo A, Sanou I, Pare J, Konate A, Pagnoni F. Severe malaria in Burkina Faso: influence of age and transmission level on clinical presentation. Am J Trop Med Hyg. 1998;59:539–542. - PubMed
    1. Marsh K, Snow RW. Malaria transmission and morbidity. Parassitologia. 1999;41:241–246. - PubMed

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