Age-Patterns of Malaria Vary with Severity, Transmission Intensity and Seasonality in Sub-Saharan Africa: A Systematic Review and Pooled Analysis

摘要: There is evidence that the age-pattern of Plasmodium falciparum malaria varies with transmission intensity. A better understanding how this severity outcome and across a range settings could enable locally appropriate targeting interventions to those most at risk. We have, therefore, undertaken pooled analysis existing data from multiple sites comprehensive overview age-patterns outcomes under different epidemiological conditions in sub-Saharan Africa.; systematic review using PubMed CAB Abstracts (1980-2005), contacts experts searching bibliographies identified studies on age distribution children P. clinical malaria, hospital admissions malaria-diagnosed mortality. Studies were allocated 3x2 matrix intensity seasonality transmission. Maximum likelihood methods used fit five continuous probability distributions percentage each by for six scenarios. The best-fitting are presented graphically, together estimated median outcome. Clinical incidence was relatively evenly distributed first 10 years life all Hospital more concentrated younger children, effect being even pronounced deaths. For outcomes, burden shifted towards ages increasing intensity, although marked moderated effect. severe consequences youngest groups settings. Despite recently observed declines several countries, which will shift cases older it still target strategies preventing mortality morbidity very young who continue bear brunt deaths Africa.