Clinical consequences of submicroscopic malaria parasitaemia in Uganda
Abstract Background Submicroscopic malaria parasitaemia is common in both high- and low-endemicity settings, but its clinical consequences are unclear. Methods A cohort of 364 children (0.5–10 years of age) and 106 adults was followed from 2011 to 2016 in Tororo District, Uganda using passive survei...
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| Format: | Article |
| Language: | English |
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BMC
2018-02-01
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| Series: | Malaria Journal |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12936-018-2221-9 |
| _version_ | 1819068193088471040 |
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| author | Shereen Katrak Patience Nayebare John Rek Emmanuel Arinaitwe Joaniter I. Nankabirwa Moses Kamya Grant Dorsey Philip J. Rosenthal Bryan Greenhouse |
| author_facet | Shereen Katrak Patience Nayebare John Rek Emmanuel Arinaitwe Joaniter I. Nankabirwa Moses Kamya Grant Dorsey Philip J. Rosenthal Bryan Greenhouse |
| author_sort | Shereen Katrak |
| collection | DOAJ |
| description | Abstract Background Submicroscopic malaria parasitaemia is common in both high- and low-endemicity settings, but its clinical consequences are unclear. Methods A cohort of 364 children (0.5–10 years of age) and 106 adults was followed from 2011 to 2016 in Tororo District, Uganda using passive surveillance for malaria episodes and active surveillance for parasitaemia. Participants presented every 90 days for routine visits (n = 9075); a subset was followed every 30 days. Participants who presented with fever and a positive blood smear were treated for malaria. At all routine visits microscopy was performed and samples from subjects with a negative blood smear underwent loop-mediated isothermal amplification for detection of plasmodial DNA. Results Submicroscopic parasitaemia was common; the proportion of visits with submicroscopic parasitemia was 25.8% in children and 39.2% in adults. For children 0.5–10 years of age, but not adults, having microscopic and submicroscopic parasitaemia at routine visits was significantly associated with both fever (adjusted risk ratios [95% CI], 2.64 [2.16–3.22], 1.67 [1.37–2.03]) and non-febrile illness (aRR [CI], 1.52 [1.30–1.78], 1.26 [1.09–1.47]), compared to not having parasitaemia. After stratifying by age, significant associations were seen between submicroscopic parasitaemia and fever in children aged 2–< 5 and 5–10 years (aRR [CI], 1.42 [1.03–1.98], 2.01 [1.49–2.71]), and submicroscopic parasitaemia and non-febrile illness in children aged 5–10 years (aRR [CI], 1.44 [1.17–1.78]). These associations were maintained after excluding individuals with a malaria episode within the preceding 14 or following 7 days, and after adjusting for household wealth. Conclusions Submicroscopic malaria infections were associated with fever and non-febrile illness in Ugandan children. These findings support malaria control strategies that target low-density infections. |
| first_indexed | 2024-12-21T16:30:15Z |
| format | Article |
| id | doaj.art-d59e9ddc451c4d37956678635e6e9804 |
| institution | Directory Open Access Journal |
| issn | 1475-2875 |
| language | English |
| last_indexed | 2024-12-21T16:30:15Z |
| publishDate | 2018-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Malaria Journal |
| spelling | doaj.art-d59e9ddc451c4d37956678635e6e98042022-12-21T18:57:21ZengBMCMalaria Journal1475-28752018-02-011711810.1186/s12936-018-2221-9Clinical consequences of submicroscopic malaria parasitaemia in UgandaShereen Katrak0Patience Nayebare1John Rek2Emmanuel Arinaitwe3Joaniter I. Nankabirwa4Moses Kamya5Grant Dorsey6Philip J. Rosenthal7Bryan Greenhouse8Department of Medicine, University of California San FranciscoInfectious Diseases Research CollaborationInfectious Diseases Research CollaborationInfectious Diseases Research CollaborationInfectious Diseases Research CollaborationInfectious Diseases Research CollaborationDepartment of Medicine, University of California San FranciscoDepartment of Medicine, University of California San FranciscoDepartment of Medicine, University of California San FranciscoAbstract Background Submicroscopic malaria parasitaemia is common in both high- and low-endemicity settings, but its clinical consequences are unclear. Methods A cohort of 364 children (0.5–10 years of age) and 106 adults was followed from 2011 to 2016 in Tororo District, Uganda using passive surveillance for malaria episodes and active surveillance for parasitaemia. Participants presented every 90 days for routine visits (n = 9075); a subset was followed every 30 days. Participants who presented with fever and a positive blood smear were treated for malaria. At all routine visits microscopy was performed and samples from subjects with a negative blood smear underwent loop-mediated isothermal amplification for detection of plasmodial DNA. Results Submicroscopic parasitaemia was common; the proportion of visits with submicroscopic parasitemia was 25.8% in children and 39.2% in adults. For children 0.5–10 years of age, but not adults, having microscopic and submicroscopic parasitaemia at routine visits was significantly associated with both fever (adjusted risk ratios [95% CI], 2.64 [2.16–3.22], 1.67 [1.37–2.03]) and non-febrile illness (aRR [CI], 1.52 [1.30–1.78], 1.26 [1.09–1.47]), compared to not having parasitaemia. After stratifying by age, significant associations were seen between submicroscopic parasitaemia and fever in children aged 2–< 5 and 5–10 years (aRR [CI], 1.42 [1.03–1.98], 2.01 [1.49–2.71]), and submicroscopic parasitaemia and non-febrile illness in children aged 5–10 years (aRR [CI], 1.44 [1.17–1.78]). These associations were maintained after excluding individuals with a malaria episode within the preceding 14 or following 7 days, and after adjusting for household wealth. Conclusions Submicroscopic malaria infections were associated with fever and non-febrile illness in Ugandan children. These findings support malaria control strategies that target low-density infections.http://link.springer.com/article/10.1186/s12936-018-2221-9MalariaSubmicroscopic infectionLAMPMolecular epidemiologyClinical tropical medicine |
| spellingShingle | Shereen Katrak Patience Nayebare John Rek Emmanuel Arinaitwe Joaniter I. Nankabirwa Moses Kamya Grant Dorsey Philip J. Rosenthal Bryan Greenhouse Clinical consequences of submicroscopic malaria parasitaemia in Uganda Malaria Journal Malaria Submicroscopic infection LAMP Molecular epidemiology Clinical tropical medicine |
| title | Clinical consequences of submicroscopic malaria parasitaemia in Uganda |
| title_full | Clinical consequences of submicroscopic malaria parasitaemia in Uganda |
| title_fullStr | Clinical consequences of submicroscopic malaria parasitaemia in Uganda |
| title_full_unstemmed | Clinical consequences of submicroscopic malaria parasitaemia in Uganda |
| title_short | Clinical consequences of submicroscopic malaria parasitaemia in Uganda |
| title_sort | clinical consequences of submicroscopic malaria parasitaemia in uganda |
| topic | Malaria Submicroscopic infection LAMP Molecular epidemiology Clinical tropical medicine |
| url | http://link.springer.com/article/10.1186/s12936-018-2221-9 |
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