Evidence for over-dispersion in the distribution of clinical malaria episodes in children.

It may be assumed that patterns of clinical malaria in children of similar age under the same level of exposure would follow a Poisson distribution with no over-dispersion. Longitudinal studies that have been conducted over many years suggest that some children may experience more episodes of clinic...

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Main Authors: Tabitha Wanja Mwangi, Gregory Fegan, Thomas Neil Williams, Sam Muchina Kinyanjui, Robert William Snow, Kevin Marsh
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2008-05-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC2374912?pdf=render
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author Tabitha Wanja Mwangi
Gregory Fegan
Thomas Neil Williams
Sam Muchina Kinyanjui
Robert William Snow
Kevin Marsh
author_facet Tabitha Wanja Mwangi
Gregory Fegan
Thomas Neil Williams
Sam Muchina Kinyanjui
Robert William Snow
Kevin Marsh
author_sort Tabitha Wanja Mwangi
collection DOAJ
description It may be assumed that patterns of clinical malaria in children of similar age under the same level of exposure would follow a Poisson distribution with no over-dispersion. Longitudinal studies that have been conducted over many years suggest that some children may experience more episodes of clinical malaria than would be expected. The aim of this study was to identify this group of children and investigate possible causes for this increased susceptibility.Using Poisson regression, we chose a group of children whom we designated as 'more susceptible' to malaria from 373 children under 10 years of age who were followed up for between 3 to 5 years from 1998-2003. About 21% of the children were categorized as 'more susceptible' and although they contributed only 23% of the person-time of follow-up, they experienced 55% of total clinical malaria episodes. Children that were parasite negative at all cross-sectional survey were less likely to belong to this group [AOR = 0.09, (95% CI: 0.14-0.61), p = 0.001].The pattern of clinical malaria episodes follows a negative binomial distribution. Use of lack of a clinical malaria episode in a certain time period as endpoints for intervention or immunological studies may not adequately distinguish groups who are more or less immune. It may be useful in such studies, in addition to the usual endpoint of the time to first episode, to include end points which take into account the total number of clinical episodes experienced per child.
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spelling doaj.art-a6a55977e29a4f59879020a23a44ddb72022-12-21T23:56:56ZengPublic Library of Science (PLoS)PLoS ONE1932-62032008-05-0135e219610.1371/journal.pone.0002196Evidence for over-dispersion in the distribution of clinical malaria episodes in children.Tabitha Wanja MwangiGregory FeganThomas Neil WilliamsSam Muchina KinyanjuiRobert William SnowKevin MarshIt may be assumed that patterns of clinical malaria in children of similar age under the same level of exposure would follow a Poisson distribution with no over-dispersion. Longitudinal studies that have been conducted over many years suggest that some children may experience more episodes of clinical malaria than would be expected. The aim of this study was to identify this group of children and investigate possible causes for this increased susceptibility.Using Poisson regression, we chose a group of children whom we designated as 'more susceptible' to malaria from 373 children under 10 years of age who were followed up for between 3 to 5 years from 1998-2003. About 21% of the children were categorized as 'more susceptible' and although they contributed only 23% of the person-time of follow-up, they experienced 55% of total clinical malaria episodes. Children that were parasite negative at all cross-sectional survey were less likely to belong to this group [AOR = 0.09, (95% CI: 0.14-0.61), p = 0.001].The pattern of clinical malaria episodes follows a negative binomial distribution. Use of lack of a clinical malaria episode in a certain time period as endpoints for intervention or immunological studies may not adequately distinguish groups who are more or less immune. It may be useful in such studies, in addition to the usual endpoint of the time to first episode, to include end points which take into account the total number of clinical episodes experienced per child.http://europepmc.org/articles/PMC2374912?pdf=render
spellingShingle Tabitha Wanja Mwangi
Gregory Fegan
Thomas Neil Williams
Sam Muchina Kinyanjui
Robert William Snow
Kevin Marsh
Evidence for over-dispersion in the distribution of clinical malaria episodes in children.
PLoS ONE
title Evidence for over-dispersion in the distribution of clinical malaria episodes in children.
title_full Evidence for over-dispersion in the distribution of clinical malaria episodes in children.
title_fullStr Evidence for over-dispersion in the distribution of clinical malaria episodes in children.
title_full_unstemmed Evidence for over-dispersion in the distribution of clinical malaria episodes in children.
title_short Evidence for over-dispersion in the distribution of clinical malaria episodes in children.
title_sort evidence for over dispersion in the distribution of clinical malaria episodes in children
url http://europepmc.org/articles/PMC2374912?pdf=render
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