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Title: | Risk of malaria following untreated sub-patent Plasmodium falciparum infections: Results over 4 years from a cohort in a high transmission area in Western Kenya |
Authors: | Zeno, Erica E. Obala, Andrew A. Pence, Brian Freedman, Elizabeth Mangeni, Judith N. Lin, Jessica T. Abel, Lucy Edwards, Jessie K. Gower, Emily W. Taylor, Steve M. |
Keywords: | Plasmodium falciparum Survival analysis |
Issue Date: | 2023 |
Publisher: | Oxford academic journals |
Abstract: | Background: People with suspected malaria may harbor Plasmodium falciparum undetected by rapid diagnostic test (RDT). The impact is not fully understood of these sub-patent infections on the risk of developing clinical malaria. Methods: We analyzed sub-patent P. falciparum infections using a longitudinal cohort in a high transmission site in Kenya. Weighted Kaplan-Meier models estimated the risk difference (RD) for clinical malaria during the 60 days following a symptomatic sub-patent infection. Stratum- specific estimates by age and transmission season assessed modification.Results: Over 54 months, we observed 1,128 symptomatic RDT-negative suspected malaria episodes, of which 400 (35.5%) harbored sub-patent P. falciparum. Overall 60-day risk of developing clinical malaria was low following all episodes (8.6%,95% Confidence Interval: 6.7%, 10.4%). In the low transmission season, the risk of clinical malaria was slightly higher in those with sub-patent infection, whereas the opposite was true in the high transmission season (RD low season: 2.3%, CI: 0.4%, 4.2%; RD high season: -4.8%, CI: -9.5%, -0.05%). Conclusions: The risk of developing clinical malaria among people with undetected sub-patent infections is low. A slightly elevated risk in the low season may merit alternate management, but RDTs diagnose clinically-relevant infections in the high transmission season. |
URI: | https://doi.org/10.1093/infdis/jiad398 http://ir.mu.ac.ke:8080/jspui/handle/123456789/8078 |
Appears in Collections: | School of Nursing |
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