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Malaria prevalence ‘sizable’ among infants in endemic countries
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Malaria appears to be more pervasive among young infants living in malaria-endemic countries than once believed, according to recent findings.
In a cross-sectional survey, researchers evaluated 6,761 infants in three West African countries: The Gambia, which represented a region of low malaria transmission; Benin, an area of moderate malaria transmission; and Guinea, which represented a high-transmission country. The researchers reviewed delivery records in the 6 months before the survey to identify households with infants for enrollment. After enrolling an index infant, the researchers chose two other children within the same household (aged 1 to 9 years and aged 10 to 15 years) using random sampling to differentiate transmission and local risk for malaria infection between infants and older siblings.
Study participants underwent physical examinations, blood sample collection and weight and temperature measurements. Questionnaires were used to determine the use of bed nets, including long-lasting insecticidal nets, and history of fever within the past 24 hours. Blood samples were assayed, and children testing positive were promptly treated. Malaria antibody prevalence testing and molecular diagnosis of Plasmodium species also were performed.
The overall rate of malaria among infants aged 6 months or younger was 11.8% (21.7% in Guinea, 10.2% in Benin and 3.7% in The Gambia), and seroprevalence ranged from 5.7% in The Gambia to 41.6% in Guinea. In the Gambia and Benin, infants had significantly lower mean parasite densities vs. children aged 1 to 9 years (P < .0001 for The Gambia; P = .0021 for Benin). Infants with malaria also were significantly associated with fever or recent febrile history (P = .007) and anemia (P = .001).
In the Gambia and Benin, more than 90% of children aged 0 to 6 months and aged 1 to 9 years reportedly were covered by bed nets; however, bed net coverage was uniformly low across all age groups in Guinea. Approximately 30% of children aged younger than 10 years and 14% of children aged 10 to 15 years slept within netting.
The researchers said this inadequate protection against malaria is alarming, adding that infants may become anemic after developing malaria.
“The prevalence of malaria is sizable among young infants living in malaria-endemic countries,” the researchers wrote. “This problem must be addressed through the development of adequate pediatric drug formulations, targeted preventive interventions, and treatment guidelines for young infants.”
Disclosure : The study was funded by Medicines for Malaria Venure and Novartis Pharma AG. One researcher is an employee of Novartis Pharmaceuticals. All other researchers report no relevant financial disclosures.
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