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Measuring malaria morbidity in an area of seasonal transmission: Pyrogenic parasitemia thresholds based on a 20-year follow-up study

Identifieur interne : 000015 ( France/Analysis ); précédent : 000014; suivant : 000016

Measuring malaria morbidity in an area of seasonal transmission: Pyrogenic parasitemia thresholds based on a 20-year follow-up study

Auteurs : Marion Dollat [Sénégal] ; Cheikh Talla [Sénégal] ; Cheikh Sokhna [France] ; Fatoumata Diene Sarr [Sénégal] ; Jean-Francois Trape [France] ; Vincent Richard [Sénégal]

Source :

RBID : Hal:hal-02508073

English descriptors

Abstract

Asymptomatic carriage of P. falciparum is frequent in areas endemic for malaria and individual diagnosis of clinical malaria attacks is still difficult. We investigated the impact of changes in malaria endemicity on the diagnostic criteria for malaria attacks in an area of seasonal malaria transmission.METHODS: We analyzed the longitudinal data collected over 20 years from a daily survey of all inhabitants of Ndiop, a rural community in central Senegal, in a logistic regression model to investigate the relationship between the level of Plasmodium falciparum parasitemia and the risk of fever, with the aim of determining the best parasitemia thresholds for attributing to malaria a fever episode.RESULTS: A total of 34,136 observations recorded from July 1993 to December 2013 from 850 individuals aged from 1 day to 87 years were included. P. falciparum asymptomatic carriage declined from 36% to 1% between 1993 and 2013. A total of 9,819 fever episodes were associated with a positive blood film for P. falciparum. Using age-dependent parasitemia thresholds for attributing to malaria a fever episode, we recorded 6,006 malaria attacks during the study period. Parasitemia thresholds seemed to be lower during the low-to-zero transmission season and tended to decrease with changes in control policies. The number of clinical malaria attacks was overestimated for all age groups throughout the study when all fever episodes associated with P. falciparum parasitemia were defined as malaria attacks.CONCLUSION: Pyrogenic thresholds are particularly sensitive to changes in malaria epidemiology and are therefore an interesting tool to accurately assess the burden of malaria in the context of declining transmission.


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DOI: 10.1371/journal.pone.0217903


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Hal:hal-02508073

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<addrLine>36, Avenue Pasteur B.P. 220 - Dakar</addrLine>
<country key="SN"></country>
</address>
</desc>
<listRelation>
<relation active="#struct-42095" type="direct"></relation>
<relation active="#struct-301247" type="indirect"></relation>
</listRelation>
<tutelles>
<tutelle active="#struct-42095" type="direct">
<org type="institution" xml:id="struct-42095" status="VALID">
<orgName>Institut Pasteur de Dakar</orgName>
<desc>
<address>
<addrLine>B.P. 220 Dakar</addrLine>
<country key="SN"></country>
</address>
<ref type="url">http://www.pasteur.sn/</ref>
</desc>
<listRelation>
<relation active="#struct-301247" type="direct"></relation>
</listRelation>
</org>
</tutelle>
<tutelle active="#struct-301247" type="indirect">
<org type="regroupinstitution" xml:id="struct-301247" status="VALID">
<orgName>Réseau International des Instituts Pasteur</orgName>
<orgName type="acronym">RIIP</orgName>
<desc>
<address>
<addrLine>25, rue du Dr Roux 75724 Paris Cedex 15</addrLine>
<country key="FR"></country>
</address>
<ref type="url">https://research.pasteur.fr/ip-network</ref>
</desc>
</org>
</tutelle>
</tutelles>
</hal:affiliation>
<country>Sénégal</country>
</affiliation>
</author>
</analytic>
<idno type="DOI">10.1371/journal.pone.0217903</idno>
<series>
<title level="j">PLoS ONE</title>
<idno type="ISSN">1932-6203</idno>
<imprint>
<date type="datePub">2019-06-27</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc>
<textClass>
<keywords scheme="mix" xml:lang="en">
<term>Chloroquine</term>
<term>Fevers</term>
<term>Malaria</term>
<term>Malarial parasites</term>
<term>Parasitemia</term>
<term>Parasitic diseases</term>
<term>Plasmodium</term>
<term>Quinine</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front>
<div type="abstract" xml:lang="en">
<p>Asymptomatic carriage of P. falciparum is frequent in areas endemic for malaria and individual diagnosis of clinical malaria attacks is still difficult. We investigated the impact of changes in malaria endemicity on the diagnostic criteria for malaria attacks in an area of seasonal malaria transmission.METHODS: We analyzed the longitudinal data collected over 20 years from a daily survey of all inhabitants of Ndiop, a rural community in central Senegal, in a logistic regression model to investigate the relationship between the level of Plasmodium falciparum parasitemia and the risk of fever, with the aim of determining the best parasitemia thresholds for attributing to malaria a fever episode.RESULTS: A total of 34,136 observations recorded from July 1993 to December 2013 from 850 individuals aged from 1 day to 87 years were included. P. falciparum asymptomatic carriage declined from 36% to 1% between 1993 and 2013. A total of 9,819 fever episodes were associated with a positive blood film for P. falciparum. Using age-dependent parasitemia thresholds for attributing to malaria a fever episode, we recorded 6,006 malaria attacks during the study period. Parasitemia thresholds seemed to be lower during the low-to-zero transmission season and tended to decrease with changes in control policies. The number of clinical malaria attacks was overestimated for all age groups throughout the study when all fever episodes associated with P. falciparum parasitemia were defined as malaria attacks.CONCLUSION: Pyrogenic thresholds are particularly sensitive to changes in malaria epidemiology and are therefore an interesting tool to accurately assess the burden of malaria in the context of declining transmission.</p>
</div>
</front>
</TEI>
<affiliations>
<list>
<country>
<li>France</li>
<li>Sénégal</li>
</country>
<region>
<li>Provence-Alpes-Côte d'Azur</li>
</region>
<settlement>
<li>Marseille</li>
</settlement>
<orgName>
<li>Université d'Aix-Marseille</li>
</orgName>
</list>
<tree>
<country name="Sénégal">
<noRegion>
<name sortKey="Dollat, Marion" sort="Dollat, Marion" uniqKey="Dollat M" first="Marion" last="Dollat">Marion Dollat</name>
</noRegion>
<name sortKey="Diene Sarr, Fatoumata" sort="Diene Sarr, Fatoumata" uniqKey="Diene Sarr F" first="Fatoumata" last="Diene Sarr">Fatoumata Diene Sarr</name>
<name sortKey="Richard, Vincent" sort="Richard, Vincent" uniqKey="Richard V" first="Vincent" last="Richard">Vincent Richard</name>
<name sortKey="Talla, Cheikh" sort="Talla, Cheikh" uniqKey="Talla C" first="Cheikh" last="Talla">Cheikh Talla</name>
</country>
<country name="France">
<region name="Provence-Alpes-Côte d'Azur">
<name sortKey="Sokhna, Cheikh" sort="Sokhna, Cheikh" uniqKey="Sokhna C" first="Cheikh" last="Sokhna">Cheikh Sokhna</name>
</region>
<name sortKey="Trape, Jean Francois" sort="Trape, Jean Francois" uniqKey="Trape J" first="Jean-Francois" last="Trape">Jean-Francois Trape</name>
</country>
</tree>
</affiliations>
</record>

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