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Am. J. Trop. Med. Hyg., 60(4), 1999, pp. 641-648
Copyright © 1999 by The American Society of Tropical Medicine and Hygiene

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American Journal of Tropical Medicine and Hygiene, Vol 60, Issue 4, 641-648
Copyright © 1999 by American Society of Tropical Medicine and Hygiene

Research Articles


Longitudinal cohort study of the epidemiology of malaria infections in an area of intense malaria transmission II. Descriptive epidemiology of malaria infection and disease among children

PB Bloland, DA Boriga, TK Ruebush, JB McCormick, JM Roberts, AJ Oloo, W Hawley, A Lal, B Nahlen, and CC Campbell

A large-scale longitudinal cohort project was initiated in western Kenya in June 1992. Between June 1992 and July 1994, 1,848 children less than 15 years of age were monitored prospectively for a mean of 236 days. During this period, 12,035 blood smears were examined for malaria and only 34% were found to be negative. Parasite prevalence (all species) decreased with age (from a high of 83% among children 1-4 years old to 60% among children 10-14 years old). Even more dramatic decreases were noted in the prevalence of high density falciparum infection (from 37% among children 12-23 months old to < 1% among 10-14-year-old children) and in clinical malaria (20% to 0.3% in the same age groups). Children < 1 year of age accounted for 55% of all cases of anemia detected. Anemia was consistently associated with high density infection in children < 10 years of age (20% to 210% increased risk relative to aparasitemic children). These results demonstrate the relationship between high-density malaria infection and two clinical manifestations of malarial illness.


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J. E. GIMNIG, M. S. KOLCZAK, A. W. HIGHTOWER, J. M. VULULE, E. SCHOUTE, L. KAMAU, P. A. PHILLIPS-HOWARD, F. O. TER KUILE, B. L. NAHLEN, and W. A. HAWLEY
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