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Infección por malaria y riesgos de enfermedades graves en África
Robert S Paton1, Alice Kamau2,3, Samuel Akech4
1Department of Zoology, University of Oxford, Oxford, UK. robert.paton@zoo.ox.ac.uk akamau@kemri-wellcome.org.
Science (New York, N.Y.)
|August 20, 2021
Resumen
Una mayor prevalencia de Plasmodium falciparum duplica las admisiones de malaria severa en niños de África Oriental. Los niños pequeños de 3 a 59 meses son los más afectados por la malaria severa a través de diversos niveles de infección por parásitos en la comunidad.
Área de la Ciencia:
- Salud global
- Enfermedades infecciosas
- Epidemiología
Sus antecedentes:
- No se comprende bien el vínculo entre la prevalencia de Plasmodium falciparum (malaria) en la comunidad y la carga grave de la enfermedad.
- La malaria grave representa una amenaza significativa, especialmente para los niños pequeños en las regiones endémicas.
Objetivo del estudio:
- Cuantificar la asociación entre la prevalencia del parásito de la malaria en la comunidad y los fenotipos graves de la malaria en los niños de África oriental.
- Para analizar la carga de la malaria severa a través de un espectro de niveles de infección por Plasmodium falciparum.
Principales métodos:
- Se compiló un conjunto de datos de 6506 hospitalizaciones pediátricas por malaria (de 3 meses a 9 años) entre 2006 y 2020 en África Oriental.
- Los datos de admisión se vincularon con las encuestas de prevalencia de la infección por Plasmodium falciparum en la comunidad.
- Se empleó un enfoque estadístico bayesiano para modelar las relaciones exposición-resultado, teniendo en cuenta las incertidumbres.
Principales resultados:
- Un aumento del 25% en la prevalencia de Plasmodium falciparum en la comunidad se asoció con un aumento del doble en las tasas de admisión de malaria grave.
- Las admisiones graves de malaria afectaron predominantemente a niños de 3 a 59 meses.
- Los hallazgos fueron válidos en una amplia gama de niveles de prevalencia típicos de la comunidad del este de África.
Conclusiones:
- La prevalencia de parásitos en la comunidad es un fuerte predictor de hospitalizaciones graves de malaria en niños.
- Los niños pequeños (3-59 meses) se ven afectados de manera desproporcionada por la malaria grave, independientemente de la prevalencia.
- Este estudio proporciona un marco cuantitativo para vincular la intensidad de transmisión de la malaria con los resultados de la enfermedad grave.
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