Age-Patterns of Malaria Vary with Severity, Transmission Intensity and Seasonality in Sub-Saharan Africa A Systematic Review and Pooled Analysis 英文参考文献.docVIP
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Age-Patterns of Malaria Vary with Severity, Transmission Intensity and Seasonality in Sub-Saharan Africa A Systematic Review and Pooled Analysis 英文参考文献
Age-PatternsofMalariaVarywithSeverity,Transmission
IntensityandSeasonalityinSub-SaharanAfrica:A
SystematicReviewandPooledAnalysis
IlonaCarneiro1*,ArantxaRoca-Feltrer1,JamieT.Griffin2,LucySmith1,MarcelTanner3 ,Joanna
ArmstrongSchellenberg1,BrianGreenwood1,DavidSchellenberg1
1DiseaseControlandVectorBiologyUnit,DepartmentofInfectiousandTropicalDiseases,LondonSchoolofHygieneandTropicalMedicine,London,UnitedKingdom,
2DepartmentofInfectiousDiseaseEpidemiology,MRCCentreforOutbreakAnalysisandModelling,ImperialCollegeLondon,London,UnitedKingdom,3SwissTropical
Institute,Basel,Switzerland
Abstract
Background:Thereisevidencethattheage-patternofPlasmodiumfalciparummalariavarieswithtransmissionintensity.A
better understanding of how this varies with the severity of outcome andacross a range of transmission settings could
enablelocallyappropriatetargetingofinterventionstothosemostatrisk.Wehave,therefore,undertakenapooledanalysis
ofexistingdatafrommultiplesitestoenableacomprehensiveoverviewoftheage-patternsofmalariaoutcomesunder
differentepidemiologicalconditionsinsub-SaharanAfrica.
Methodology/PrincipalFindings:AsystematicreviewusingPubMedandCABAbstracts(1980–2005),contactswithexperts
and searching bibliographies identified epidemiological studies with data on the age distribution of children with P.
falciparumclinicalmalaria,hospitaladmissionswithmalariaandmalaria-diagnosedmortality.Studieswereallocatedtoa
362 matrix of intensity and seasonality of malaria transmission. Maximum likelihood methods were used to fit five
continuousprobabilitydistributionstothepercentageofeachoutcomebyageforeachofthesixtransmissionscenarios.
Thebest-fittingdistributionsarepresentedgraphically,togetherwiththeestimatedmedianageforeachoutcome.Clinical
malaria incidence was relatively evenly distributed across the first 10 years of life for all transmission scenarios. Hospital
admissions with malaria were more concentrated in younger children, withthis effect being even more pronounced for
malaria-diagn
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