Citation
Sumner, Kelsey M.; Mangeni, Judith N.; Obala, Andrew A.; Freedman, Elizabeth; Abel, Lucy; Meshnick, Steven R.; Edwards, Jessie K.; Pence, Brian W.; Prudhomme-O'Meara, Wendy; & Taylor, Steve M (2021). Impact of Asymptomatic Plasmodium Falciparum Infection on the Risk of Subsequent Symptomatic Malaria in a Longitudinal Cohort in Kenya. Elife, 10, e68812. PMCID: PMC8337072Abstract
BACKGROUND: Asymptomatic Plasmodium falciparum infections are common in sub-Saharan Africa, but their effect on subsequent symptomaticity is incompletely understood.METHODS: In a 29-month cohort of 268 people in Western Kenya, we investigated the association between asymptomatic P. falciparum and subsequent symptomatic malaria with frailty Cox models.
RESULTS: Compared to being uninfected, asymptomatic infections were associated with an increased 1 month likelihood of symptomatic malaria (adjusted hazard ratio [aHR]: 2.61, 95% CI: 2.05 to 3.33), and this association was modified by sex, with females (aHR: 3.71, 95% CI: 2.62 to 5.24) at higher risk for symptomaticity than males (aHR: 1.76, 95% CI: 1.24 to 2.50). This increased symptomatic malaria risk was observed for asymptomatic infections of all densities and in people of all ages. Long-term risk was attenuated but still present in children under age 5 (29-month aHR: 1.38, 95% CI: 1.05 to 1.81).
CONCLUSIONS: In this high-transmission setting, asymptomatic P. falciparum can be quickly followed by symptoms and may be targeted to reduce the incidence of symptomatic illness.
URL
http://dx.doi.org/10.7554/eLife.68812Reference Type
Journal ArticleYear Published
2021Journal Title
ElifeAuthor(s)
Sumner, Kelsey M.Mangeni, Judith N.
Obala, Andrew A.
Freedman, Elizabeth
Abel, Lucy
Meshnick, Steven R.
Edwards, Jessie K.
Pence, Brian W.
Prudhomme-O'Meara, Wendy
Taylor, Steve M