Risk of Plasmodium falciparum infection during a malaria epidemic in highland Kenya, 1997.
Malaria epidemics in highland areas of East Africa have occurred with increasing frequency since the late 1980s, but the actual risk of Plasmodium falciparum infection in children and adults during these epidemics has not been well characterized. During a malaria epidemic in a highland area of Kenya, risk of infection was assessed in 50 adults (> or =18 years old) and 32 children (< or =8 years old) after treatment and parasitologic clearance with sulfadoxine-pyrimethamine treatment. Over a 10-week period, 36 of the 82 study participants (43.9%) became infected. The risk of infection was similar in children and adults (hazard ratio for children = 1.21, 95% CI: 0.63-2.33). These findings contrast with the age-related protection from infection reported in areas of stable, intense transmission, and demonstrate that during malaria epidemics, both children and adults in highland areas of Kenya are at high risk of infection.
Rainbow Center for International Child Health, Rainbow Babies and Children's Hospital, Case Western Reserve University, RBC 487, 11100 Euclid Avenue, MS6008, Cleveland, OH 44106, USA. chandy.john@case.edu
Chandy C
CC
John
David K
DK
Koech
P Odada
PO
Sumba
John H
JH
Ouma
D000293:Adolescent; D000328:Adult; D000368:Aged; D000962:Antimalarials / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004196:Disease Outbreaks; D004338:Drug Combinations; D006801:Humans; D007223:Infant; D007630:Kenya / Q000453:epidemiology; D016778:Malaria, Falciparum / Q000188:drug therapy / Q000453:epidemiology*; D008875:Middle Aged; D011446:Prospective Studies; D011739:Pyrimethamine / Q000627:therapeutic use; D012306:Risk; D013413:Sulfadoxine / Q000627:therapeutic use; D013997:Time Factors
D000962:Antimalarials; D004338:Drug Combinations; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D011739:Pyrimethamine