title: Spatio-Temporal Variations in Malaria Incidence in Children Less than 10 Years Old, Health District of Sokone, Senegal, 2010-2013.
abstract: BACKGROUND
  Malaria is a leading cause of morbidity and mortality in sub-Saharan Africa. Detailed characterization of the risks for malaria, among populations living in areas where the disease is endemic, is an important priority, especially for planning and evaluating future malaria-control tools. A prospective cohort study was implemented in children under ten years living in rural areas with high Plasmodium falciparum transmission in Senegal.
  
  
  METHODS
  Malaria incidence was prospectively evaluated over three year follow-up among a cohort of children aged less than 10 years old living in eight villages of the Sokone health district. The parents of 1316 children comprising a passive case detection cohort were encouraged to seek care from the study health centers at any time their child felt sick. In the event of reported history of fever within 24 hours or measured axillary temperature ≥ 37.5°C, a Rapid Diagnostic Test (RDT) was performed.
  
  
  RESULTS
  From November 2010 to October 2013, among the 1468 reported febrile episodes, 264 were confirmed malaria episodes. Over the 3 years, 218 (16.9%) children experienced at least one clinical malaria episode. Cumulative malaria incidence was 7.3 episodes per 100 children-year at risk, with remarkably heterogeneous rates from 2.5 to 10.5 episodes per 100 children-year at risk. Clinical malaria prevalence ranged from 11.5 to 28.4% in the high transmission season versus from 9.6 to 21.2% in the low transmission season.
  
  
  CONCLUSIONS
  This longitudinal community-based study shows that occurrence of clinical malaria was not evenly distributed among all the cohort children in the eight villages. It demonstrates the complexity of spatial distribution of malaria incidence at a local level, even in a region of vegetation and altitudinal homogeneity.
authors.affiliation: Epidemiology Unit, Pasteur Institute of Dakar, Dakar, Senegal.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Espié
authors.affiliation: Epidemiology Unit, Pasteur Institute of Dakar, Dakar, Senegal.
authors.forename: Fatoumata
authors.initials: F
authors.lastname: Diene Sarr
authors.affiliation: Immunology Unit, Pasteur Institute of Dakar, Dakar, Senegal; Laboratory of Parasitology-Biology, Faculty of Sciences and Technology, University Cheikh Anta Diop, Dakar, Senegal.
authors.forename: Fodé
authors.initials: F
authors.lastname: Diop
authors.affiliation: Epidemiology Unit, Pasteur Institute of Dakar, Dakar, Senegal.
authors.forename: Joseph
authors.initials: J
authors.lastname: Faye
authors.affiliation: Epidemiology Unit, Pasteur Institute of Dakar, Dakar, Senegal.
authors.forename: Vincent
authors.initials: V
authors.lastname: Richard
authors.affiliation: Epidemiology Unit, Pasteur Institute of Dakar, Dakar, Senegal.
authors.forename: Adama
authors.initials: A
authors.lastname: Tall
authors.affiliation: Immunology Unit, Pasteur Institute of Dakar, Dakar, Senegal.
authors.forename: Aissatou
authors.initials: A
authors.lastname: Touré Baldé
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008288:Malaria / Q000453:epidemiology*; D008297:Male; D015995:Prevalence; D012675:Senegal / Q000453:epidemiology