| dc.description.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. |
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