Paton RS
Kamau A
Akech S
Agweyu A
Ogero M
Mwandawiro C
Mturi N
Mohammed S
Mpimbaza A
Kariuki S
Otieno NA
Nyawanda BO
Mohamed AF
Mtove G
Reyburn H
Gupta S
Bejon P
Lourenco J
Snow RW
Science. 2021;373926-931
The relationship between community prevalence of Plasmodium falciparum and the burden of severe, life-threatening disease remains poorly defined. To examine the three most common severe malaria phenotypes from catchment populations across East Africa, we assembled a dataset of 6506 hospital admissions for malaria in children aged 3 months to 9 years from 2006 to 2020. Admissions were paired with data from community parasite infection surveys. A Bayesian procedure was used to calibrate uncertainties in exposure (parasite prevalence) and outcomes (severe malaria phenotypes). Each 25% increase in prevalence conferred a doubling of severe malaria admission rates. Severe malaria remains a burden predominantly among young children (3 to 59 months) across a wide range of community prevalence typical of East Africa. This study offers a quantitative framework for linking malaria parasite prevalence and severe disease outcomes in children.
