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Identification of different malaria patterns due to Plasmodium falciparum and Plasmodium vivax in Ethiopian children : a prospective cohort study

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Abstract
Background: The identification of epidemiological pattern of infection with Plasmodium falciparum and Plasmodium vivax in malaria-endemic area, where multiple episodes are common, is important for intervention programmes. Methods: A longitudinal cohort study based on weekly house-to-house visits was conducted between July 2008 and June 2010 in 2040 children less than 10 years of age, living nearby the Gilgel-Gibe hydroelectric power dam reservoir in order to determine factors associated with increased P. vivax and P. falciparum incidence. Two types of multivariate frailty models were applied (using time-to-first malaria episode data and time-to-recurrent malaria episode data), allowing the estimation of adjusted hazard ratios (AHR) of potential risk factors (gender, age, proximity to the dam reservoir, and season) for species-specific malaria incidence. Results: Of 2040 children in 96 weeks of follow up, 864 children experienced at least one malaria episode: 685 due to P. falciparum in 548 children, and 385 due to P. vivax in 316 children. Plasmodium vivax and P. falciparum malaria incidence rates were 8.2 (95 % CI: 7.3-9.1) and 14.6 (95 % CI: 13.4-15.6) per 1000 children per month, respectively. According to the time-to-recurrent event models, children aged >= 7 years had a lower risk of presenting P. vivax episodes (AHR = 0.6; 95 % CI: 0.4-0.9), but a higher risk of P. falciparum episodes, when compared with children under <= 3 years (AHR = 1.2; 95 % CI: 1.1-1.6). In addition, P. vivax (AHR = 2.7; 95 % CI: 2.2-3.5) and P. falciparum (AHR = 16.9; 95 % CI: 14.3-20.2) episodes were respectively 2.7 and 16.9 times more frequent in the dry season than in the long rainy season. Conclusions: The analysis of all malaria episodes (first and recurrent episodes) in the malaria cohort suggests different species-specific patterns of malaria disease in children, with mild seasonality in the incidence of P. vivax episodes mostly observed in younger age groups, and with marked seasonality in the incidence of P. falciparum episodes mainly seen in older children.
Keywords
PENALIZED LIKELIHOOD ESTIMATION, DISCONTINUOUS RISK INTERVALS, NEW-GUINEAN CHILDREN, RECURRENT EVENTS, FRAILTY MODELS, RESERVOIR, IMPACT, TIME, DAM, INFECTION, Frailty model, Recurrent malaria, Plasmodium vivax, Plasmodium, falciparum, Ethiopia

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Chicago
Seyoum, Dinberu, Yehenew Getachew Kifle, Virginie Rondeau, Delenasaw Yewhalaw, Luc Duchateau, Angel Rosas-Aguirre, and Niko Speybroeck. 2016. “Identification of Different Malaria Patterns Due to Plasmodium Falciparum and Plasmodium Vivax in Ethiopian Children : a Prospective Cohort Study.” Malaria Journal 15.
APA
Seyoum, D., Kifle, Y. G., Rondeau, V., Yewhalaw, D., Duchateau, L., Rosas-Aguirre, A., & Speybroeck, N. (2016). Identification of different malaria patterns due to Plasmodium falciparum and Plasmodium vivax in Ethiopian children : a prospective cohort study. MALARIA JOURNAL, 15.
Vancouver
1.
Seyoum D, Kifle YG, Rondeau V, Yewhalaw D, Duchateau L, Rosas-Aguirre A, et al. Identification of different malaria patterns due to Plasmodium falciparum and Plasmodium vivax in Ethiopian children : a prospective cohort study. MALARIA JOURNAL. 2016;15.
MLA
Seyoum, Dinberu, Yehenew Getachew Kifle, Virginie Rondeau, et al. “Identification of Different Malaria Patterns Due to Plasmodium Falciparum and Plasmodium Vivax in Ethiopian Children : a Prospective Cohort Study.” MALARIA JOURNAL 15 (2016): n. pag. Print.
@article{8538002,
  abstract     = {Background: The identification of epidemiological pattern of infection with Plasmodium falciparum and Plasmodium vivax in malaria-endemic area, where multiple episodes are common, is important for intervention programmes. 
Methods: A longitudinal cohort study based on weekly house-to-house visits was conducted between July 2008 and June 2010 in 2040 children less than 10 years of age, living nearby the Gilgel-Gibe hydroelectric power dam reservoir in order to determine factors associated with increased P. vivax and P. falciparum incidence. Two types of multivariate frailty models were applied (using time-to-first malaria episode data and time-to-recurrent malaria episode data), allowing the estimation of adjusted hazard ratios (AHR) of potential risk factors (gender, age, proximity to the dam reservoir, and season) for species-specific malaria incidence. 
Results: Of 2040 children in 96 weeks of follow up, 864 children experienced at least one malaria episode: 685 due to P. falciparum in 548 children, and 385 due to P. vivax in 316 children. Plasmodium vivax and P. falciparum malaria incidence rates were 8.2 (95 \% CI: 7.3-9.1) and 14.6 (95 \% CI: 13.4-15.6) per 1000 children per month, respectively. According to the time-to-recurrent event models, children aged {\textrangle}= 7 years had a lower risk of presenting P. vivax episodes (AHR = 0.6; 95 \% CI: 0.4-0.9), but a higher risk of P. falciparum episodes, when compared with children under {\textlangle}= 3 years (AHR = 1.2; 95 \% CI: 1.1-1.6). In addition, P. vivax (AHR = 2.7; 95 \% CI: 2.2-3.5) and P. falciparum (AHR = 16.9; 95 \% CI: 14.3-20.2) episodes were respectively 2.7 and 16.9 times more frequent in the dry season than in the long rainy season. 
Conclusions: The analysis of all malaria episodes (first and recurrent episodes) in the malaria cohort suggests different species-specific patterns of malaria disease in children, with mild seasonality in the incidence of P. vivax episodes mostly observed in younger age groups, and with marked seasonality in the incidence of P. falciparum episodes mainly seen in older children.},
  articleno    = {208},
  author       = {Seyoum, Dinberu and Kifle, Yehenew Getachew and Rondeau, Virginie and Yewhalaw, Delenasaw and Duchateau, Luc and Rosas-Aguirre, Angel and Speybroeck, Niko},
  issn         = {1475-2875},
  journal      = {MALARIA JOURNAL},
  keyword      = {PENALIZED LIKELIHOOD ESTIMATION,DISCONTINUOUS RISK INTERVALS,NEW-GUINEAN CHILDREN,RECURRENT EVENTS,FRAILTY MODELS,RESERVOIR,IMPACT,TIME,DAM,INFECTION,Frailty model,Recurrent malaria,Plasmodium vivax,Plasmodium,falciparum,Ethiopia},
  language     = {eng},
  pages        = {11},
  title        = {Identification of different malaria patterns due to Plasmodium falciparum and Plasmodium vivax in Ethiopian children : a prospective cohort study},
  url          = {http://dx.doi.org/10.1186/s12936-016-1253-2},
  volume       = {15},
  year         = {2016},
}

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