Estimating the Number of Paediatric Fevers Associated with Malaria Infection Presenting to Africas Public Health Sector in 2007 英文参考文献.docVIP

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Estimating the Number of Paediatric Fevers Associated with Malaria Infection Presenting to Africas Public Health Sector in 2007 英文参考文献.doc

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Estimating the Number of Paediatric Fevers Associated with Malaria Infection Presenting to Africas Public Health Sector in 2007 英文参考文献

EstimatingtheNumberofPaediatricFeversAssociated withMalariaInfectionPresentingtoAfrica’sPublic HealthSectorin2007 PeterW.Gething1*,ViolaC.Kirui2,VictorA.Alegana2,EmeldaA.Okiro2,3,AbdisalanM.Noor2,3 , RobertW.Snow2,3 1Spatial Ecology and EpidemiologyGroup, Department of Zoology, University of Oxford, Oxford, United Kingdom, 2Malaria Public Health and Epidemiology Group, Centre for Geographic Medicine, KEMRI–University of Oxford–Wellcome Trust Collaborative Programme, Nairobi, Kenya, 3Centre for Tropical Medicine, Nuffield DepartmentofClinicalMedicine,UniversityofOxford,Oxford,UnitedKingdom Abstract Background:Asinternationaleffortstoincreasethecoverageofartemisinin-basedcombinationtherapyinpublichealth sectorsgatherpace,concernshavebeenraisedregardingtheircontinuedindiscriminatepresumptiveusefortreatingall childhood fevers. The availability of rapid-diagnostic tests to support practical and reliable parasitological diagnosis providesanopportunitytoimprovetherationaltreatmentoffebrilechildrenacrossAfrica.However,thecosteffectiveness of diagnosis-based treatment polices will depend on the presumed numbers of fevers harbouring infection. Here we computethenumberoffeverslikelytopresenttopublichealthfacilitiesinAfricaandtheestimatednumberofthesefevers likelytobeinfectedwithPlasmodiumfalciparummalariaparasites. MethodsandFindings:Weassembledfirstadministrative-unitleveldataonpaediatricfeverprevalence,treatment-seeking rates,andchildpopulations.Thesedatawerecombinedinageographicalinformationsystemmodelthatalsoincorporated anadjustmentprocedureforurbanversusruralareastoproducespatiallydistributedestimatesoffeverburdenamongst African children and the subset likely to present to public sector clinics. A second data assembly was used to estimate plausible ranges for the proportion of paediatric fevers seen at clinics positive for P. falciparum in different endemicity settings.Weestimatedthat,ofthe656millionfeversinAfrican0–4yoldsin2007,182million(28%)werelikelytohave soughttrea