title: Uncommon asymptomatic Plasmodium falciparum infections in Gabonese children.
abstract: To assess the frequency of asymptomatic plasmodial infections in young children living in an area of hyperendemicity, a cohort of 200 children in Gabon was investigated longitudinally. Of 660 cases of Plasmodium falciparum infection, 77% were symptomatic at the time they were identified and only 7% were preceded by an asymptomatic phase of >4 days. Sickle cell trait, glucose-6-phosphate dehydrogenase deficiency, and mutation in the promoter region of tumor necrosis factor (TNF(-376A/-238A)) were significantly associated with asymptomatic P. falciparum infection (P=.03, P=.009, and P<.001, respectively). We conclude that true asymptomatic cases of P. falciparum infection are uncommon in young children and that single measurements or measurements made at long time intervals will lead to a strong underestimation of the incidence of malaria.
authors.affiliation: Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon.
authors.forename: Michel A
authors.initials: MA
authors.lastname: Missinou
authors.forename: Bertrand
authors.initials: B
authors.lastname: Lell
authors.forename: Peter G
authors.initials: PG
authors.lastname: Kremsner
mesh_terms: D000818:Animals; D002675:Child, Preschool; D005260:Female; D005681:Gabon / Q000453:epidemiology; D006801:Humans; D008137:Longitudinal Studies; D016778:Malaria, Falciparum / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology*; D008297:Male; D010963:Plasmodium falciparum