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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
agricultural and biological sciences
Severe childhood malaria in two areas of markedly different falciparum transmission in East Africa
Acta Tropica, Volume 57, No. 4, Year 1994
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Description
Malaria remains a major public health challenge in sub-Saharan Africa, yet our knowledge of the epidemiology of malaria in terms of patterns of mortality and morbidity is limited. We have examined the presentation of severe, potentially life-threatening malaria to district hospitals in two very different transmission settings: Kilifi, Kenya with low seasonal transmission and Ifakara, Tanzania with high seasonal transmission. The minimum annual rates of severe disease in children below five years in both populations were similar (46 per 1000 children in Kilifi and 51 per 1000 children in Ifakara). However, there were important differences in the age and clinical patterns of severe disease; twice as many patients were under one year of age in Ifakara compared with Kilifi and there was a four fold higher rate of cerebral malaria and three fold lower rate of malaria anaemia among malaria patients at Kilifi compared with Ifakara. Reducing malaria transmission in Ifakara by 95%, for example with insecticide-treated bed nets, would result in a transmission setting comparable to that of Kilifi and although this reduction may yield early successes in reducing severe malaria morbidity and mortality in young, immunologically naive children, place these same children at increased risk at older ages of developing severe and potentially different manifestations of malaria infection hence producing no net cohort gain in survivorship from potentially fatal malaria. © 1994.
Authors & Co-Authors
Snow, Robert William
Kenya, Nairobi
Kenya Medical Research Institute
United Kingdom, Oxford
Nuffield Department of Medicine
Bastos de Azevedo, I.
Tanzania, Tanga
National Institute for Medical Research Tanga
Lowe, Brett S.
Kenya, Nairobi
Kenya Medical Research Institute
United Kingdom, Oxford
Nuffield Department of Medicine
United Kingdom, Liverpool
Liverpool School of Tropical Medicine
Kabiru, Ephantus Wanjohi
Kenya, Nairobi
Kenya Medical Research Institute
Kenya, Nairobi
Ministry of Health Nairobi
Nevill, Chris G.
Kenya, Nairobi
Kenya Medical Research Institute
Kenya, Nairobi
Amref Health Africa
Tanzania
St. Francis Designated District Hospital
Mwankusye, Samuel
Tanzania, Tanga
National Institute for Medical Research Tanga
Kassiga, George I.
Kenya, Nairobi
Amref Health Africa
Tanzania
St. Francis Designated District Hospital
Marsh, Kevin
Kenya, Nairobi
Kenya Medical Research Institute
United Kingdom, Oxford
Nuffield Department of Medicine
Teuscher, Thomas M.
Tanzania, Tanga
National Institute for Medical Research Tanga
Statistics
Citations: 243
Authors: 9
Affiliations: 7
Identifiers
Doi:
10.1016/0001-706X(94)90074-4
ISSN:
0001706X
Research Areas
Infectious Diseases
Maternal And Child Health
Study Design
Cohort Study
Study Locations
Multi-countries
Kenya
Tanzania