Submicroscopic malaria infection is not associated with fever in cross-sectional studies in Malawi
Abstract Background Submicroscopic Plasmodium falciparum infections are widespread in many areas. However, the contribution of these infections to symptomatic malaria is not well understood. This study evaluated whether participants with submicroscopic P. falciparum infections have higher prevalence...
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doaj-0fe679fdb702436c9c52ac28250140cc2020-11-25T03:02:18ZengBMCMalaria Journal1475-28752020-06-011911810.1186/s12936-020-03296-4Submicroscopic malaria infection is not associated with fever in cross-sectional studies in MalawiJimmy Vareta0Andrea G. Buchwald1Angelica Barrall2Lauren M. Cohee3Jenny A. Walldorf4Jenna E. Coalson5Karl Seydel6Alick Sixpence7Don P. Mathanga8Terrie E. Taylor9Miriam K. Laufer10Center for Vaccine Development and Global Health, University of Maryland School of MedicineCenter for Vaccine Development and Global Health, University of Maryland School of MedicineSchool of Public Health, University of Maryland College ParkCenter for Vaccine Development and Global Health, University of Maryland School of MedicineCenter for Vaccine Development and Global Health, University of Maryland School of MedicineDepartment of Epidemiology, University of Michigan School of Public HealthDepartment of Osteopathic Medical Specialties, College of Osteopathic Medicine, Michigan State UniversityMalaria Alert Center, College of Medicine, University of MalawiMalaria Alert Center, College of Medicine, University of MalawiDepartment of Osteopathic Medical Specialties, College of Osteopathic Medicine, Michigan State UniversityCenter for Vaccine Development and Global Health, University of Maryland School of MedicineAbstract Background Submicroscopic Plasmodium falciparum infections are widespread in many areas. However, the contribution of these infections to symptomatic malaria is not well understood. This study evaluated whether participants with submicroscopic P. falciparum infections have higher prevalence of fever than uninfected participants in southern Malawi. Methods A total of 16,650 children and adults were enrolled in the course of six cross-sectional surveys during the dry season (October–November) and after the rainy season (April–May) between 2012 and 2014 in three districts in southern Malawi. Demographic and socioeconomic data were collected in conjunction with data on clinical histories, use of malaria preventive measures, and anti-malarial medication taken within 2 weeks of the survey. Axillary temperatures were measured, and blood samples were collected for P. falciparum detection by microscopy and PCR. Participants without malaria parasites detected on microscopy but with a positive PCR for P. falciparum were defined as having submicroscopic infection. Fever was defined as having any one of: reported fever in the past 2 weeks, reported fever in the past 48 h, or a temperature of ≥ 37.5 °C measured at the time of interview. Results Submicroscopic P. falciparum infections and fever were both detected in 9% of the study population. In the final analysis adjusted for clustering within household and enumeration area, having submicroscopic P. falciparum infection was associated with reduced odds of fever in the dry season (odds ratio = 0.52; 95% CI 0.33–0.82); the association in the rainy season did not achieve statistical significance (odds ratio = 1.20; 95% CI 0.91–1.59). The association between submicroscopic infection and fever was consistent across all age groups. When the definition of fever was limited to temperature of ≥ 37.5 °C measured at the time of interview, the association was not statistically significant in either the rainy or dry season. Conclusions In this series of cross-sectional studies in southern Malawi, submicroscopic P. falciparum infection was not associated with increased risk of fever. Submicroscopic detection of the malaria parasite is important in efforts to decrease transmission but is not essential for the clinical recognition of malaria disease.http://link.springer.com/article/10.1186/s12936-020-03296-4MalariaSubmicroscopic infectionPlasmodium falciparum |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jimmy Vareta Andrea G. Buchwald Angelica Barrall Lauren M. Cohee Jenny A. Walldorf Jenna E. Coalson Karl Seydel Alick Sixpence Don P. Mathanga Terrie E. Taylor Miriam K. Laufer |
spellingShingle |
Jimmy Vareta Andrea G. Buchwald Angelica Barrall Lauren M. Cohee Jenny A. Walldorf Jenna E. Coalson Karl Seydel Alick Sixpence Don P. Mathanga Terrie E. Taylor Miriam K. Laufer Submicroscopic malaria infection is not associated with fever in cross-sectional studies in Malawi Malaria Journal Malaria Submicroscopic infection Plasmodium falciparum |
author_facet |
Jimmy Vareta Andrea G. Buchwald Angelica Barrall Lauren M. Cohee Jenny A. Walldorf Jenna E. Coalson Karl Seydel Alick Sixpence Don P. Mathanga Terrie E. Taylor Miriam K. Laufer |
author_sort |
Jimmy Vareta |
title |
Submicroscopic malaria infection is not associated with fever in cross-sectional studies in Malawi |
title_short |
Submicroscopic malaria infection is not associated with fever in cross-sectional studies in Malawi |
title_full |
Submicroscopic malaria infection is not associated with fever in cross-sectional studies in Malawi |
title_fullStr |
Submicroscopic malaria infection is not associated with fever in cross-sectional studies in Malawi |
title_full_unstemmed |
Submicroscopic malaria infection is not associated with fever in cross-sectional studies in Malawi |
title_sort |
submicroscopic malaria infection is not associated with fever in cross-sectional studies in malawi |
publisher |
BMC |
series |
Malaria Journal |
issn |
1475-2875 |
publishDate |
2020-06-01 |
description |
Abstract Background Submicroscopic Plasmodium falciparum infections are widespread in many areas. However, the contribution of these infections to symptomatic malaria is not well understood. This study evaluated whether participants with submicroscopic P. falciparum infections have higher prevalence of fever than uninfected participants in southern Malawi. Methods A total of 16,650 children and adults were enrolled in the course of six cross-sectional surveys during the dry season (October–November) and after the rainy season (April–May) between 2012 and 2014 in three districts in southern Malawi. Demographic and socioeconomic data were collected in conjunction with data on clinical histories, use of malaria preventive measures, and anti-malarial medication taken within 2 weeks of the survey. Axillary temperatures were measured, and blood samples were collected for P. falciparum detection by microscopy and PCR. Participants without malaria parasites detected on microscopy but with a positive PCR for P. falciparum were defined as having submicroscopic infection. Fever was defined as having any one of: reported fever in the past 2 weeks, reported fever in the past 48 h, or a temperature of ≥ 37.5 °C measured at the time of interview. Results Submicroscopic P. falciparum infections and fever were both detected in 9% of the study population. In the final analysis adjusted for clustering within household and enumeration area, having submicroscopic P. falciparum infection was associated with reduced odds of fever in the dry season (odds ratio = 0.52; 95% CI 0.33–0.82); the association in the rainy season did not achieve statistical significance (odds ratio = 1.20; 95% CI 0.91–1.59). The association between submicroscopic infection and fever was consistent across all age groups. When the definition of fever was limited to temperature of ≥ 37.5 °C measured at the time of interview, the association was not statistically significant in either the rainy or dry season. Conclusions In this series of cross-sectional studies in southern Malawi, submicroscopic P. falciparum infection was not associated with increased risk of fever. Submicroscopic detection of the malaria parasite is important in efforts to decrease transmission but is not essential for the clinical recognition of malaria disease. |
topic |
Malaria Submicroscopic infection Plasmodium falciparum |
url |
http://link.springer.com/article/10.1186/s12936-020-03296-4 |
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