Severe outcomes of malaria in children under time-varying exposure

In malaria epidemiology, interpolation frameworks based on available observations are critical for policy decisions and interpreting disease burden. Updating our understanding of the empirical evidence across different populations, settings, and timeframes is crucial to improving inference for suppo...

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Main Authors: De Salazar, PM, Kamau, A, Cavelan, A, Akech, S, Mpimbaza, A, Snow, RW, Penny, MA
Format: Journal article
Language:English
Published: Nature Research 2024
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author De Salazar, PM
Kamau, A
Cavelan, A
Akech, S
Mpimbaza, A
Snow, RW
Penny, MA
author_facet De Salazar, PM
Kamau, A
Cavelan, A
Akech, S
Mpimbaza, A
Snow, RW
Penny, MA
author_sort De Salazar, PM
collection OXFORD
description In malaria epidemiology, interpolation frameworks based on available observations are critical for policy decisions and interpreting disease burden. Updating our understanding of the empirical evidence across different populations, settings, and timeframes is crucial to improving inference for supporting public health. Here, via individual-based modeling, we evaluate a large, multicountry, contemporary Plasmodium falciparum severe malaria dataset to better understand the relationship between prevalence and incidence of malaria pediatric hospitalizations - a proxy of malaria severe outcomes- in East-Africa. We find that life-long exposure dynamics, and subsequent protection patterns in children, substantially determine the likelihood of malaria hospitalizations relative to ongoing prevalence at the population level. Unsteady transmission patterns over a lifetime in children -increasing or decreasing- lead to an exponential relationship of hospitalization rates versus prevalence rather than the asymptotic pattern observed under steady transmission. Addressing this increase in the complexity of malaria epidemiology is crucial to update burden assessments via inference models that guide current and future policy decisions.
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spelling oxford-uuid:745d83db-981f-4f2e-a79d-cb496762e1de2024-07-20T15:59:16ZSevere outcomes of malaria in children under time-varying exposureJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:745d83db-981f-4f2e-a79d-cb496762e1deEnglishJisc Publications RouterNature Research2024De Salazar, PMKamau, ACavelan, AAkech, SMpimbaza, ASnow, RWPenny, MAIn malaria epidemiology, interpolation frameworks based on available observations are critical for policy decisions and interpreting disease burden. Updating our understanding of the empirical evidence across different populations, settings, and timeframes is crucial to improving inference for supporting public health. Here, via individual-based modeling, we evaluate a large, multicountry, contemporary Plasmodium falciparum severe malaria dataset to better understand the relationship between prevalence and incidence of malaria pediatric hospitalizations - a proxy of malaria severe outcomes- in East-Africa. We find that life-long exposure dynamics, and subsequent protection patterns in children, substantially determine the likelihood of malaria hospitalizations relative to ongoing prevalence at the population level. Unsteady transmission patterns over a lifetime in children -increasing or decreasing- lead to an exponential relationship of hospitalization rates versus prevalence rather than the asymptotic pattern observed under steady transmission. Addressing this increase in the complexity of malaria epidemiology is crucial to update burden assessments via inference models that guide current and future policy decisions.
spellingShingle De Salazar, PM
Kamau, A
Cavelan, A
Akech, S
Mpimbaza, A
Snow, RW
Penny, MA
Severe outcomes of malaria in children under time-varying exposure
title Severe outcomes of malaria in children under time-varying exposure
title_full Severe outcomes of malaria in children under time-varying exposure
title_fullStr Severe outcomes of malaria in children under time-varying exposure
title_full_unstemmed Severe outcomes of malaria in children under time-varying exposure
title_short Severe outcomes of malaria in children under time-varying exposure
title_sort severe outcomes of malaria in children under time varying exposure
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