BACKGROUND: Malaria risk may be heterogeneous in urban areas of Africa. Identifying those at highest risk for malaria may lead to more targeted approaches to malaria control. METHODS: A representative sample of 558 children aged 1-10 years were recruited from a census population in a single parish of Kampala and followed up for 2 years. Malaria was diagnosed when a child presented with a new episode of fever and a thick blood smear positive for parasites. Multivariate analysis was used to identify independent predictors of malaria incidence. RESULTS: A total of 695 episodes of uncomplicated malaria were diagnosed after 901 person years of follow-up. Sickle cell trait (relative risk [RR], 0.68 [95% confidence interval {CI}, 0.52-0.90]), glucose-6-phosphate dehydrogenase deficiency in female children (RR, 0.48 [95% CI, 0.31-0.75]), and use of an insecticide-treated bed net (RR, 0.52 [95% CI, 0.32-0.83]) were associated with a lower risk of malaria. The distance of the subject's residence from a swamp bordering the parish showed a strong "dose-response" relationship; living in the swamp was the strongest predictor of malaria risk (RR, 3.94 [95% CI, 2.61-5.97]). CONCLUSION: Malaria incidence was highly heterogeneous in this urban cohort of children. Malaria control interventions in urban areas should target populations living in pockets of high malaria risk.
BACKGROUND:Malaria risk may be heterogeneous in urban areas of Africa. Identifying those at highest risk for malaria may lead to more targeted approaches to malaria control. METHODS: A representative sample of 558 children aged 1-10 years were recruited from a census population in a single parish of Kampala and followed up for 2 years. Malaria was diagnosed when a child presented with a new episode of fever and a thick blood smear positive for parasites. Multivariate analysis was used to identify independent predictors of malaria incidence. RESULTS: A total of 695 episodes of uncomplicated malaria were diagnosed after 901 person years of follow-up. Sickle cell trait (relative risk [RR], 0.68 [95% confidence interval {CI}, 0.52-0.90]), glucose-6-phosphate dehydrogenase deficiency in female children (RR, 0.48 [95% CI, 0.31-0.75]), and use of an insecticide-treated bed net (RR, 0.52 [95% CI, 0.32-0.83]) were associated with a lower risk of malaria. The distance of the subject's residence from a swamp bordering the parish showed a strong "dose-response" relationship; living in the swamp was the strongest predictor of malaria risk (RR, 3.94 [95% CI, 2.61-5.97]). CONCLUSION:Malaria incidence was highly heterogeneous in this urban cohort of children. Malaria control interventions in urban areas should target populations living in pockets of high malaria risk.
Authors: Tatiana M Lopera-Mesa; Saibou Doumbia; Drissa Konaté; Jennifer M Anderson; Mory Doumbouya; Abdoul S Keita; Seidina A S Diakité; Karim Traoré; Michael A Krause; Ababacar Diouf; Samuel E Moretz; Gregory S Tullo; Kazutoyo Miura; Wenjuan Gu; Michael P Fay; Steve M Taylor; Carole A Long; Mahamadou Diakité; Rick M Fairhurst Journal: Lancet Haematol Date: 2015-03-24 Impact factor: 18.959
Authors: Matthew B McCarra; George Ayodo; Peter O Sumba; James W Kazura; Ann M Moormann; David L Narum; Chandy C John Journal: Pediatr Infect Dis J Date: 2011-12 Impact factor: 2.129
Authors: Christian P Nixon; Christina E Nixon; Dian Sidik Arsyad; Krisin Chand; Frilasita A Yudhaputri; Wajiyo Sumarto; Suradi Wangsamuda; Puji B Asih; Sylvia S Marantina; Isra Wahid; Gang Han; Jennifer F Friedman; Michael J Bangs; Din Syafruddin; J Kevin Baird Journal: Pathog Glob Health Date: 2014-12-10 Impact factor: 2.894
Authors: Alain Nahum; Annette Erhart; Ambroisine Mayé; Daniel Ahounou; Chantal van Overmeir; Joris Menten; Harry van Loen; Martin Akogbeto; Marc Coosemans; Achille Massougbodji; Umberto D'Alessandro Journal: Am J Trop Med Hyg Date: 2010-09 Impact factor: 2.345