title: Community-wide Prevalence of Malaria Parasitemia in HIV-Infected and Uninfected Populations in a High-Transmission Setting in Uganda.
abstract: Malaria control strategies depend on identifying individuals with parasitemia, who may be asymptomatic but retain the ability to transmit disease. Population-level survey data on parasitemia are limited and traditionally exclude adults and human immunodeficiency virus (HIV)-infected individuals.
  
  
  
  We performed a cross-sectional survey of residents aged 18 months to 94 years in Nankoma, Uganda. Blood specimens were collected using the dried blood spot technique from 9629 residents (87.6%), and samples from a subset of 4131 were tested for malaria parasites, using loop-mediated isothermal amplification. Population-level prevalence was estimated using a weighted proportion, and predictors of parasitemia were identified using a multivariate Poisson regression model.
  
  
  
  The community prevalence of parasitemia was 83.8% (95% confidence interval [CI], 82.9%-84.6%). Parasite prevalence was highest among children aged 5-14 years (94.7%) and lowest among adults (61.9%). In analysis that controlled for age, HIV-infected individuals with an undetectable viral load had a lower risk of parasitemia, compared with HIV-uninfected individuals (adjusted relative risk, 0.16; 95% CI, .10-.27; P < .001).
  
  
  
  In a rural Ugandan community, 2 years after distribution of long-lasting insecticide-treated bed nets, the prevalence of malaria parasitemia was high across all ages, peaking in school-aged children. Persons with well-controlled HIV infection had a lower risk of parasitemia, presumably reflecting access to HIV care.
authors.affiliation: Department of Medicine.
authors.forename: Shereen
authors.initials: S
authors.lastname: Katrak
authors.affiliation: Vanderbilt University, Nashville, Tennessee.
authors.forename: Nathan
authors.initials: N
authors.lastname: Day
authors.affiliation: Infectious Diseases Research Collaboration.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Ssemmondo
authors.affiliation: Makerere University Joint AIDS Program.
authors.forename: Dalsone
authors.initials: D
authors.lastname: Kwarisiima
authors.affiliation: Malaria Elimination Initiative, Global Health Group, University of California-San Francisco.
authors.forename: Alemayehu
authors.initials: A
authors.lastname: Midekisa
authors.affiliation: Department of Medicine.
authors.forename: Bryan
authors.initials: B
authors.lastname: Greenhouse
authors.affiliation: School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: Moses
authors.initials: M
authors.lastname: Kamya
authors.affiliation: Department of Medicine.
authors.forename: Diane
authors.initials: D
authors.lastname: Havlir
authors.affiliation: Department of Medicine.
authors.forename: Grant
authors.initials: G
authors.lastname: Dorsey
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000821:virology; D015497:HIV-1 / Q000502:physiology*; D006801:Humans; D007223:Infant; D057148:Insecticide-Treated Bednets; D008288:Malaria / Q000453:epidemiology* / Q000469:parasitology; D008297:Male; D008875:Middle Aged; D018512:Parasitemia / Q000453:epidemiology*; D010961:Plasmodium / Q000502:physiology*; D015995:Prevalence; D012424:Rural Population; D014454:Uganda / Q000453:epidemiology; D055815:Young Adult
keywords: HIV; LAMP; malaria; parasitemia