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

Doris P. Yimgang Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland;

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Andrea G. Buchwald Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland;

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Jenna E. Coalson University of Michigan School of Public Health, Ann Arbor, Michigan;

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Jenny A. Walldorf Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland;

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Andy Bauleni Malaria Alert Center, University of Malawi College of Medicine, Blantyre, Malawi;

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Atupele Kapito-Tembo Malaria Alert Center, University of Malawi College of Medicine, Blantyre, Malawi;

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Don P. Mathanga Malaria Alert Center, University of Malawi College of Medicine, Blantyre, Malawi;

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Terrie E. Taylor Department of Osteopathic Medical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan

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Miriam K. Laufer Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland;

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Lauren M. Cohee Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland;

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DOI:
https://doi.org/10.4269/ajtmh.20-1120
Volume/Issue:
Volume 104: Issue 3
Page(s):
1013–1017
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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.

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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.

Copyright:
© The American Society of Tropical Medicine and Hygiene 2021
Received:
01 Sep 2020
|
Accepted:
16 Nov 2020
|
Published Online:
04 Jan 2021
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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