“Asymptomatic” Malaria: A Chronic and Debilitating Infection That Should Be Treated

Chen, Ingrid; Clarke, Siân E.; Gosling, Roly; Hamainza, Busiku; Killeen, Gerry F.; Magill, Alan J.; O’Meara, Wendy Prudhomme; Price, Ric N.; Riley, Eleanor M.

doi:10.1371/journal.pmed.1001942

Cited by 309 publications

(347 citation statements)

References 63 publications

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“…Impaired phagocytosis by dendritic cells has been associated with submicroscopic parasitemia in malaria-naive adult volunteers experimentally challenged with P. falciparum-IEs (45). These data lend support to the assessment that the term "asymptomatic parasitemia" is inaccurate and should instead be referred to as "chronic malaria infection," given the detrimental effects that even low-density infections may have on innate immune functions and individual health and development (in addition to serious societal and public health concerns) (46,47). Impairment in monocyte phagocytosis was observed across the clinical spectrum of P. falciparum infection in this cohort, and further research is required to elucidate the underlying mechanisms.…”

Section: Cd16mentioning

confidence: 73%

Monocyte dysregulation and systemic inflammation during pediatric falciparum malaria

Dobbs¹,

Embury²,

Vulule³

et al. 2017

JCI Insight

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Section: Cd16mentioning

confidence: 73%

Monocyte dysregulation and systemic inflammation during pediatric falciparum malaria

Dobbs¹,

Embury²,

Vulule³

et al. 2017

JCI Insight

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“…20 % of children had a positive malaria test but no clinical signs or symptoms. While some of these children may have already been successfully treated for malaria, the higher serum CRP and AGP levels in children with a positive RDT without fever indicate a presence of asymptomatic malaria, which has previously been shown to have health consequences [31].…”

Section: Discussionmentioning

confidence: 99%

Children with moderate acute malnutrition have inflammation not explained by maternal reports of illness and clinical symptoms: a cross-sectional study in Burkina Faso

et al. 2016

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Background: Morbidity plays an important role in the development of and recovery from malnutrition. Morbidity in children with moderate acute malnutrition (MAM) has not been described in detail and it is unclear how morbidity compares to serum levels of acute phase proteins (APPs) which indicate systemic inflammation and which can impede response to therapeutic nutritional interventions. The objective of this study was to describe morbidity in children with MAM and to assess to what extent maternally reported and clinically diagnosed morbidity explain the variation in APPs. Methods: A cross-sectional sub study was conducted as part of a nutrition intervention trial among 6-23 months old children with MAM residing in Burkina Faso. Morbidity data collection at baseline included 2 week maternal recalls and physical examinations. Multivariate ANCOVA models were used to explore the associations between morbidity and C-reactive protein (CRP) as well as α 1 -acid glycoprotein (AGP). These models were also used to determine to what extent morbidity explains variation in APPs.

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“…The indirect costs of disease, including lost productivity, are rarely documented but can be substantial, particularly as children who bear the highest burden of disease will require a caretaker. Finally, the impact of malaria episodes on educational and developmental attainment are increasingly recognized, but again the evidence base for vivax is less established than that for P. falciparum [60,74]. For example, a number of studies have…”

Section: The Economics Of P Vivax Treatmentmentioning

confidence: 99%

The Economics of Vivax Malaria Treatment

Devine¹

2018

Preprint

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The control and eventual elimination of malaria will require widescale adoption of strategies to ensure early diagnosis and highly effective treatment of infected individuals. In Plasmodium vivax, multiple relapse episodes can only be averted by treating the dormant liver stage of the parasite life cycle -a strategy known as radical cure. This thesis aims to investigate key factors determining treatment-seeking behaviour and costs associated with vivax malaria, how these influence healthcare decisions, the cost-effectiveness of screening tests and treatments for radical cure, and the cost-benefit implications of their global implementation.Treatment-seeking behaviour, assessed in Papua, Indonesia, demonstrated that household costs per person seeking treatment for vivax malaria were similar to those for falciparum malaria. Switching from ineffective to effective malaria treatment in the public sector improved the behaviour of patients and both public and private healthcare providers. Diagnostic strategies were investigated on the Thai-Myanmar border, where screening for glucose-6-phosphate-dehydrogenase (G6PD) deficiency prior to radical cure reduced the disease burden while being a cost-effective option for healthcare providers that do not use radical cure and a potentially cost-saving alternative where primaquine is prescribed without screening. The costs of implementing G6PD screening were collected in three countries, and highlighted that RDTs consistently reduced costs as compared to the widely-used fluorescent spot test. Across four countries, the indirect cost due to lost productivity was the largest cost component for households of patients with vivax malaria. After combining provider and patient costs with case estimates, the global economic burden of vivax malaria was estimated to be US$330 million per year. Adopting a policy of screening for G6PD deficiency with delivery of highly effective radical cure was projected to save US$45 million.P. vivax malaria causes a large economic burden that can be reduced substantially by delivering safe and effective radical cure.iii iv

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“Asymptomatic” Malaria: A Chronic and Debilitating Infection That Should Be Treated

Abstract: Roland Gosling and colleagues argue that "asymptomatic" malaria infections have significant health and societal consequences, and propose that they should be renamed "chronic" malaria infections.

Cited by 309 publications

References 63 publications

Monocyte dysregulation and systemic inflammation during pediatric falciparum malaria

Monocyte dysregulation and systemic inflammation during pediatric falciparum malaria

Children with moderate acute malnutrition have inflammation not explained by maternal reports of illness and clinical symptoms: a cross-sectional study in Burkina Faso

The Economics of Vivax Malaria Treatment

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