@article{fdi:010095476,
  title = {{P}lasmodium falciparum carriage in a population under longterm, intensive malaria control in {K}edougou region, {S}enegal : a 1-year cohort study},
  author = {{L}egendre, {E}. and {B}a, {E}hkc and {L}'{O}llivier, {C}. and {C}issoko, {M}. and {K}atile, {A}. and {M}ehadji, {M}. and {S}erre, {P}. and {S}okhna, {C}heikh and {R}anque, {S}. and {D}anfakha, {F}. and {B}endiane, {M}. {K}. and {S}agara, {I}. and {G}audart, {J}. and {L}andier, {J}ordi},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {I}n {S}ahelian {A}frica, successful interventions against malaria include vector control, improved access to care, and seasonal malaria chemoprevention ({SMC}) in children. {H}owever, malaria incidence has increased in the past 5 years. {U}p-to-date evidence is necessary to design additional interventions and restore progress towards elimination. {I}n this study, we aimed to describe subclinical {P}lasmodium falciparum infections in the general population and understand the changes in prevalence, parasite densities, and clinical incidence across age groups and seasons, and to identify factors associated with {P} falciparum carriage in {K}edougou, {S}enegal's most affected region. {M}ethods {W}e included all individuals older than 6 months from randomly selected households of four villages in a 1-year open cohort. {D}uring four surveys spanning the dry and wet seasons, we collected sociodemographic and behavioural data, and detected {P} falciparum using quantitative {PCR} on capillary dried blood samples. {W}e analysed risk factors associated with {P} falciparum carriage using multilevel logistic regression. {F}indings {W}e included 763 participants from 69 households, and they were followed up from {A}pril 13, 2021, to {M}arch 30, 2022. {P} falciparum prevalence was lowest in {SMC}-eligible children (aged <10 years) and remained below 10% across wet and dry seasons. {O}lder age groups had similar dry season prevalence at baseline (10-15%). {D}uring the wet season, prevalence increased in individuals aged 15-24 years (32<middle dot>1%) and 35-49 years (24<middle dot>7%). {T}he highest clinical burden was in participants aged 10-14 years (527 cases per 1000 person-years) and 15-19 years (631 cases per 1000 person-years), over five-fold higher than children aged 6 months to 4 years (93 cases per 1000 person-years). {O}utdoor night-time activity was associated with {P} falciparum infection. {I}nterpretation {I}n this setting, ongoing intensive control reduced malaria in {SMC}-eligible children. {O}lder individuals bear an important clinical burden and harbour high prevalence during the wet season. {E}limination-oriented interventions must tackle the parasite reservoir, involving whole communities and specifically young adults.},
  keywords = {{SENEGAL}},
  booktitle = {},
  journal = {{L}ancet {G}lobal {H}ealth},
  volume = {13},
  numero = {11},
  pages = {1935--1945},
  ISSN = {2214-109{X}},
  year = {2025},
  URL = {https://www.documentation.ird.fr/hor/fdi:010095476},
}