• 1.

    Kassebaum NJ 2016. The global burden of anemia. Hematol Oncol Clin North Am 30: 247308.

  • 2.

    Balarajan Y, Ramakrishnan U, Özaltin E, Shankar AH, Subramanian SV, 2011. Anaemia in low-income and middle-income countries. Lancet 378: 21232135.

    • Search Google Scholar
    • Export Citation
  • 3.

    The DHS Program, 2020. Research Topics - Anemia. Available at: https://dhsprogram.com/topics/Anemia.cfm. Accessed July 6, 2020.

  • 4.

    Nkulikiyinka R, Binagwaho A, Palmer K, 2015. The changing importance of key factors associated with anaemia in 6- to 59-month-old children in a sub-Saharan African setting where malaria is on the decline: analysis of the Rwanda Demographic and Health Survey 2010. Trop Med Int Heal 20: 17221732.

    • Search Google Scholar
    • Export Citation
  • 5.

    Soares Magalhães RJ, Clements ACA, 2011. Mapping the risk of anaemia in preschool-age children: the contribution of malnutrition, malaria, and helminth infections in West Africa. PLoS Med 8: e1000438.

    • Search Google Scholar
    • Export Citation
  • 6.

    Korenromp EL, Armstrong-Schellenberg JRM, Williams BG, Nahlen BL, Snow RW, 2004. Impact of malaria control on childhood anaemia in Africa -- a quantitative review. Trop Med Int Health 9: 10501065.

    • Search Google Scholar
    • Export Citation
  • 7.

    Guyatt HL, Brooker S, Kihamia CM, Hall A, Bundy DAP, 2001. Evaluation of efficacy of school-based anthelmintic treatments against anaemia in children in the United Republic of Tanzania. Bull World Health Organ 79: 695703.

    • Search Google Scholar
    • Export Citation
  • 8.

    Bundy DAP, de Silva N, Horton S, Jamison DT, Patton GC, eds., 2017. Child and Adolescent Health and Development. Disease Control Priorities (third edition), Volume 8. Washington, DC: World Bank. doi: 10.1596/978-1-4648-0423-6.

    • Search Google Scholar
    • Export Citation
  • 9.

    Walldorf JA 2015. School-age children are a reservoir of malaria infection in Malawi. PLoS One 10: e0134061.

  • 10.

    WHO, 2011. Haemoglobin Concentrations for the Diagnosis of Anaemia and Assessment of Severity. Vitamin and Mineral Nutrition Information System. Geneva, Switzerland: World Health Organization. (WHO/NMH/NHD/MNM/11.1). Available at: www.who.int/vmnis/indicators/haemoglobin.pdf. Accessed July 12, 2020.

    • Search Google Scholar
    • Export Citation
  • 11.

    The RTS,S Clinical Trials Partnership, 2012. A phase 3 trial of RTS,S/AS01 malaria vaccine in african infants. N Engl J Med 367: 22842295.

    • Search Google Scholar
    • Export Citation
  • 12.

    Rockhill B, Newman B, Weinberg C, 1998. Use and Misuse of Population Attributable Fractions. Am J Public Health 88: 115119.

  • 13.

    Olapeju B 2018. Age and gender trends in insecticide-treated net use in sub-Saharan Africa: a multi-country analysis. Malar J 17: 423.

  • 14.

    Buchwald AG 2016. Bed net use among school-aged children after a universal bed net campaign in Malawi. Malar J 15: 127.

  • 15.

    Coalson JE, Cohee LM, Walldorf JA, Bauleni A, Mathanga DP, Taylor TE, Wilson ML, Laufer MK, 2019. Challenges in treatment for fever among school-age children and adults in Malawi. Am J Trop Med Hyg 100: 287295.

    • Search Google Scholar
    • Export Citation
  • 16.

    Chen I, Clarke SE, Gosling R, Hamainza B, Killeen G, Magill A, O’Meara W, Price RN, Riley EM, 2016. “Asymptomatic” malaria: a chronic and debilitating infection that should be treated. PLoS Med 13: e1001942.

    • Search Google Scholar
    • Export Citation
  • 17.

    Malawi National Malaria Control Program and ICF International, 2015. Malawi: Malaria Indicator Survey (MIS) 2014. Available at: http://dhsprogram.com/pubs/pdf/MIS18/MIS18.pdf. Accessed November 15, 2020.

    • Search Google Scholar
    • Export Citation
  • 18.

    Ehrhardt S, Burchard GD, Mantel C, Cramer JP, Kaiser S, Kubo M, Otchwemah RN, Bienzle U, Mockenhaupt FP, 2006. Malaria, anemia, and malnutrition in african children—defining intervention priorities. J Infect Dis 194: 108114.

    • Search Google Scholar
    • Export Citation
  • 19.

    Valice EM 2018. Relative contribution of schistosomiasis and malaria to anemia in western Kenya. Am J Trop Med Hyg 99: 713715.

  • 20.

    Makaula P, Sadalaki JR, Muula AS, Kayuni S, Jemu S, Bloch P, 2014. Schistosomiasis in Malawi: a systematic review. Parasit Vectors 7: 570.

  • 21.

    Chipeta MG, Ngwira B, Kazembe LN, 2013. Analysis of Schistosomiasis haematobium infection prevalence and intensity in Chikhwawa, Malawi: an application of a two part model. PLoS Negl Trop Dis 7: e2131.

    • Search Google Scholar
    • Export Citation
  • 22.

    Bowie C, Purcell B, Shaba B, Makaula P, Perez M, 2004. A national survey of the prevalence of schistosomiasis and soil transmitted helminths in Malaŵi. BMC Infect Dis 4: 49.

    • Search Google Scholar
    • Export Citation
  • 23.

    Msyamboza K, Ngwira B, Banda R, Mkwanda S, Brabin B, 2010. Sentinel surveillance of lymphatic filariasis, schistosomiasis, soil transmitted helminths and malaria in rural southern Malawi. Malawi Med J 22: 1214.

    • Search Google Scholar
    • Export Citation
  • 24.

    Phiri BBW, Ngwira B, Kazembe LN, 2016. Analysing risk factors of co-occurrence of Schistosomiasis haematobium and hookworm using bivariate regression models: case study of Chikwawa, Malawi. Parasite Epidemiol Control 1: 149158.

    • Search Google Scholar
    • Export Citation
  • 25.

    Cohee LM 2020. Preventive malaria treatment among school-age children in sub-Saharan Africa: a systematic review and meta-analyses. Lancet Glob Heal 8: e1499e1511.

    • Search Google Scholar
    • Export Citation
  • 26.

    Filmer D, Pritchett LH, 2001. Estimating wealth effects without expenditure data - or tears: an application to educational enrollments in states of India. Demography 38: 115132.

    • Search Google Scholar
    • Export Citation

 

 

 

 

Population Attributable Fraction of Anemia Associated with Plasmodium falciparum Infection in Children in Southern Malawi

View More View Less
  • 1 Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland;
  • 2 University of Michigan School of Public Health, Ann Arbor, Michigan;
  • 3 Malaria Alert Center, University of Malawi College of Medicine, Blantyre, Malawi;
  • 4 Department of Osteopathic Medical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan

ABSTRACT

Anemia is a leading cause of morbidity in sub-Saharan Africa. The etiologies of anemia are multifactorial, and it is unclear what proportion of anemia is attributable to malaria in children of different ages in Malawi. We evaluated the population attributable fraction (PAF) of anemia due to malaria using multiple cross-sectional surveys in southern Malawi. We found a high prevalence of anemia, with the greatest proportion attributable to malaria among school-age children (5–15 years) in the rainy season (PAF = 18.8% [95% CI: 16.3, 21.0], compared with PAF = 5.2% [95% CI: 4.0, 6.2] among young children pooled across season [< 5 years] and PAF = 9.7% [95% CI: 6.5, 12.4] among school-age children in the dry season). Malaria control interventions will likely lead to decreases in anemia, especially among school-age children.

    • Supplementary Materials

Author Notes

Address correspondence to Lauren M. Cohee, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, 685W, Baltimore St., HSF-1 Rm. 480, Baltimore, MD 21201. E-mail: lcohee@som.umaryland.edu

Financial support: This study was funded by the U.S. National Institutes of Health U19AI089683 (T. E. T.), K24AI114996 (M. K. L.), K23AI135076 (L. M. C.), and F31HD095615 (D. P. Y.).

Authors’ addresses: Doris P. Yimgang, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, E-mail: doris_yimgang@umaryland.edu. Andrea G. Buchwald, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, and Department of Environmental and Occupational Health, Colorado School of Public Health, Denver, CO, E-mail: andrea.buchwald@cuanschutz.edu. Jenna E. Coalson, University of Michigan School of Public Health, Ann Arbor, MI, and Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, E-mail: jcoalson@nd.edu. Jenny A. Walldorf, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, and Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, E-mail: jwalldorf@cdc.gov. Andy Bauleni, Atupele Kapito-Tembo, and Don P. Mathanga, University of Malawi College of Medicine, Blantyre, Malawi, E-mail: abauleni@mac.medcol.mw, atupelekapito@gmail.com, and dmathang@mac.medcol.mw. Terrie E. Taylor, Department of Osteopathic Medicical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, E-mail: ttmalawi@msu.edu. Miriam K. Laufer and Lauren M. Cohee, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, E-mails: mlaufer@som.umaryland.edu and lcohee@som.umaryland.edu.

Save