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Am. J. Trop. Med. Hyg., 71(2 suppl), 2004, pp. 71-79
Copyright © 2004 by The American Society of Tropical Medicine and Hygiene

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DESCRIBING THE BURDEN OF MALARIA ON CHILD DEVELOPMENT: WHAT SHOULD WE BE MEASURING AND HOW SHOULD WE BE MEASURING IT?

PENNY A. HOLDING AND PATRICIA K. KITSAO-WEKULO
Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom; The Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute, Kilifi, Kenya

There are a number of pathways, both direct and indirect, through which malaria infection could impact the course of child development, causing impairment and disability and adding to the burden of malaria. We present an overview of relevant studies that illustrate these pathways, updating the evidence previously presented. We conclude that before the mechanisms and numbers of affected children can be adequately defined, a wider range of potential pathways to impaired development need to be investigated. Only then can the calculation of the burden be evidence-based, rather than merely speculative. Priorities for future research are described. The calculation of the impact of malaria on child development also requires a degree of uniformity in the definition of outcome across studies. This is currently lacking, and suggestions are made for a common approach to the reporting of results.

Received August 21, 2003. Accepted for publication January 22, 2004.

Acknowledgments: This paper is published with the permission of the Director of the Kenya Medical Research Institute.

Financial support: Penny A. Holding received support from The Wellcome Trust as part of their Advanced Training Fellowships in Tropical Medicine (# GR064702MA)

Authors’ addresses: Penny A. Holding, Center for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, John Radcliffe Hospital, Oxford, OX2 39U, United Kingdom, Telephone: 254-41-522-063, Fax: 254-41-522-390, E-mail: pholding{at}kilifi.mimcom.net. Patricia K. Kitsao-Wekulo, The Center for Geographic Medicine Research (Coast), Kenya Medical Research Institute, PO Box 230, Kilifi, Kenya.






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Copyright © 2004 by the American Society of Tropical Medicine and Hygiene.