title: Estimates of the changing age-burden of Plasmodium falciparum malaria disease in sub-Saharan Africa.
abstract: Estimating the changing burden of malaria disease remains difficult owing to limitations in health reporting systems. Here, we use a transmission model incorporating acquisition and loss of immunity to capture age-specific patterns of disease at different transmission intensities. The model is fitted to age-stratified data from 23 sites in Africa, and we then produce maps and estimates of disease burden. We estimate that in 2010 there were 252 (95% credible interval: 171-353) million cases of malaria in sub-Saharan Africa that active case finding would detect. However, only 34% (12-86%) of these cases would be observed through passive case detection. We estimate that the proportion of all cases of clinical malaria that are in under-fives varies from above 60% at high transmission to below 20% at low transmission. The focus of some interventions towards young children may need to be reconsidered, and should be informed by the current local transmission intensity.
authors: MRC Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, Imperial College London, London W2 1PG, UK.
authors: Jamie T
authors: JT
authors: Griffin
authors: MRC Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, Imperial College London, London W2 1PG, UK.
authors: Neil M
authors: NM
authors: Ferguson
authors: MRC Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, Imperial College London, London W2 1PG, UK.
authors: Azra C
authors: AC
authors: Ghani
mesh_terms: D000293:Adolescent; D017954:Africa South of the Sahara / Q000453:epidemiology; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016778:Malaria, Falciparum / Q000453:epidemiology* / Q000635:transmission; D015233:Models, Statistical; D015995:Prevalence; D055815:Young Adult