@article{fdi:010057299,
  title = {{C}hanging malaria epidemiology and diagnostic criteria for {P}lasmodium falciparum clinical malaria},
  author = {{R}oucher, {C}l{\'e}mentine and {R}ogier, {C}. and {D}ieye-{B}a, {F}. and {S}okhna, {C}heikh and {T}all, {A}. and {T}rape, {J}ean-{F}ran{\c{c}}ois},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {I}n tropical {A}frica, where malaria is highly endemic, low grade infections are asymptomatic and the diagnosis of clinical malaria is usually based on parasite density. {H}ere we investigate how changes in malaria control and endemicity modify diagnostic criteria of {P}lasmodium falciparum attacks. {M}ethods and {F}indings: {P}arasitological and clinical data from the population of {D}ielmo, {S}enegal, monitored during 20 years, are analyzed in a random-effect logistic regression model to investigate the relationship between the level of parasitemia and risk of fever. {B}etween 1990 and 2010, {P}. falciparum prevalence in asymptomatic persons declined from 85% to 1% in children 0-3 years and from 34% to 2% in adults >= 50 years. {T}hresholds levels of parasitemia for attributing fever episodes to malaria decreased by steps in relation to control policies. {U}sing baseline threshold during following periods underestimated {P}. falciparum attacks by 9.8-20.2% in children and 18.9-40.2% in adults. {C}onsidering all fever episodes associated with malaria parasites as clinical attacks overestimated {P}. falciparum attacks by 42.2-68.5% in children and 45.9-211.7% in adults. {C}onclusions: {M}alaria control modifies in all age-groups the threshold levels of parasitemia to be used for the assessment of malaria morbidity and to guide therapeutic decisions. {E}ven under declining levels of malaria endemicity, the parasite density method must remain the reference method for distinguishing malaria from other causes of fever and assessing trends in the burden of malaria.},
  keywords = {},
  booktitle = {},
  journal = {{P}los {O}ne},
  volume = {7},
  numero = {9},
  pages = {e46188},
  ISSN = {1932-6203},
  year = {2012},
  DOI = {10.1371/journal.pone.0046188},
  URL = {https://www.documentation.ird.fr/hor/fdi:010057299},
}