Rogier C., Commenges D., Trape Jean-François. (1996). Evidence for an age-dependent pyrogenic threshold of Plasmodium falciparum parasitemia in highly endemic populations. American Journal of Tropical Medicine and Hygiene, 54 (6), p. 613-619. ISSN 0002-9637.
Titre du document
Evidence for an age-dependent pyrogenic threshold of Plasmodium falciparum parasitemia in highly endemic populations
Année de publication
1996
Type de document
Article
Auteurs
Rogier C., Commenges D., Trape Jean-François
Source
American Journal of Tropical Medicine and Hygiene, 1996,
54 (6), p. 613-619 ISSN 0002-9637
The high prevalence of asymptomatic malaria infections and the nonspecific signs and symptoms of the disease make the individual diagnosis of clinical malaria uncertain in highly endemic areas. Longitudinal data obtained during a four-month period from a daily survey of 200 permanent inhabitants (one month-83 years old) living in a holoendemic area were analyzed in a random-effects logistic regression model to investigate the relationship between the level of Plasmodium falciparum parasitemia and risk of fever. It was not possible to build a model that described/summarized correctly this relationship by a continuous function. Findings provide evidence for an age-dependent threshold effect of parasitemia on the occurrence of fever. The level of this threshold varied by 2.45 trophozoites per leukocyte, maximum at one year of age, to 0.5 trophozoites per leukocyte, minimum at 60 years of age. When the parasite density of a person crossed the threshold level corresponding to his or her age, the individual's risk of fever was multiplied by 44 (95% confidence interval = 13.6-144.8). The existence of this threshold effect allows parasite density to be used to distinguish malaria attacks from other causes of fever within an individual and should facilitate the accurate evaluation of the incidence of clinical malaria in highly endemic areas. (Résumé d'auteur)
