Research Articles

Relationship between parasite density and fever risk in a community exposed to a low level of malaria transmission in Madagascar highlands

To establish a simple definition of a malaria attack based on blood parasite density and other explanatory covariates, a cohort study was conducted from 1993 to 1996 in the Madagascar highlands undergoing a low seasonal transmission of falciparum malaria. Using logistic regression, the explanatory variables found to be significantly related to the risk of fever are parasite density, age, season, and year. However, and in contrast with other studies, we found no evidence of a clear cutoff in parasite density values consistent with the concept of "pyrogenic threshold" despite a gradual increase of the risk of fever with increasing parasite density. Furthermore, the model evidenced an individual-dependent relationship at a given age. This point was in accordance with the immunological data recorded from the participants. The investigators conclude that the parasite density to distinguish malaria attacks from other causes of fever is not reliable in a context of low falciparum transmission.

This article has been cited by other articles:

				C. K. Murray, R. A. Gasser Jr., A. J. Magill, and R. S. Miller Update on Rapid Diagnostic Testing for Malaria Clin. Microbiol. Rev., January 1, 2008; 21(1): 97 - 110. [Abstract] [Full Text] [PDF]

				K. A. Koram and M. E. Molyneux When Is "Malaria" Malaria? The Different Burdens of Malaria Infection, Malaria Disease, and Malaria-Like Illnesses Am J Trop Med Hyg, December 1, 2007; 77(6_Suppl): 1 - 5. [Abstract] [Full Text] [PDF]

				T. SMITH, A. ROSS, N. MAIRE, C. ROGIER, J.-F. TRAPE, and L. MOLINEAUX AN EPIDEMIOLOGIC MODEL OF THE INCIDENCE OF ACUTE ILLNESS IN PLASMODIUM FALCIPARUM MALARIA. Am J Trop Med Hyg, August 1, 2006; 75(2_suppl): 56 - 62. [Abstract] [Full Text] [PDF]