ArticlePloS one2008
Effect of transmission setting and mixed species infections on clinical measures of malaria in Malawi.
Article in PloS one, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 1 of them a synthesis that pooled it.
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Who cites it
33 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Plasmodium spp. mixed infection leading to severe malaria: a systematic review and meta-analysis.Scientific reports · 2020Pooled it
- Assessment of the infectivity of malaria parasites from asymptomatic school children to Anopheles gambiae mosquitoes in a high transmission area in Ghana.Scientific reports · 2025Article
- Non-random distribution of Plasmodium Species infections and associated clinical features in children in the lake Victoria region, Kenya, 2012-2018.Tropical medicine and health · 2024Article
- Epidemiology of Plasmodium malariae and Plasmodium ovale spp. in Kinshasa Province, Democratic Republic of Congo.Nature communications · 2023Article
- The temporal dynamics of Plasmodium species infection after artemisinin-based combination therapy (ACT) among asymptomatic children in the Hohoe municipality, Ghana.Malaria journal · 2023Article
- Molecular epidemiology of non-falciparum Plasmodium infections in three different areas of the Ivory Coast.Malaria journal · 2023Article
- Similar Prevalence of Plasmodium falciparum and Non-P. falciparum Malaria Infections among Schoolchildren, TanzaniaEmerging infectious diseases · 2023Article
- Malaria parasite density and detailed qualitative microscopy enhances large-scale profiling of infection endemicity in Nigeria.Scientific reports · 2023Article
- Occurrence and Distribution of Nonfalciparum Malaria Parasite Species Among Adolescents and Adults in Malawi.The Journal of infectious diseases · 2022Article
- Malaria parasite species composition of Plasmodium infections among asymptomatic and symptomatic school-age children in rural and urban areas of Kinshasa, Democratic Republic of Congo.Malaria journal · 2021Article
- Under the Radar: Epidemiology of Plasmodium ovale in the Democratic Republic of the Congo.The Journal of infectious diseases · 2021Article
- High Circulation of Malaria and Low Prevalence of Bacteremia in Febrile and Afebrile Children in Northeastern Gabon.The American journal of tropical medicine and hygiene · 2020Article
- Characterization of Plasmodium infections among inhabitants of rural areas in Gabon.Scientific reports · 2019Article
- Persistent transmission of Plasmodium malariae and Plasmodium ovale species in an area of declining Plasmodium falciparum transmission in eastern Tanzania.PLoS neglected tropical diseases · 2019Article
- Simulation models predict that school-age children are responsible for most human-to-mosquito Plasmodium falciparum transmission in southern Malawi.Malaria journal · 2018Article
- Emergence of Nonfalciparum Plasmodium Infection Despite Regular Artemisinin Combination Therapy in an 18-Month Longitudinal Study of Ugandan Children and Their Mothers.The Journal of infectious diseases · 2018Article
- Direct detection of falciparum and non-falciparum malaria DNA from a drop of blood with high sensitivity by the dried-LAMP system.Parasites & vectors · 2017Article
- High prevalence of Plasmodium falciparum gametocyte infections in school-age children using molecular detection: patterns and predictors of risk from a cross-sectional study in southern Malawi.Malaria journal · 2016Article
- Seroepidemiology of Plasmodium species infections in Zimbabwean population.Malaria journal · 2016Article
- Direct and indirect determinants of childhood malaria morbidity in Malawi: a survey cross-sectional analysis based on malaria indicator survey data for 2012.Malaria journal · 2015Article
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6 authors.
Funding
Abstract
backgroundIn malaria endemic regions people are commonly infected with multiple species of malaria parasites but the clinical impact of these Plasmodium co-infections is unclear. Differences in transmission seasonality and transmission intensity between endemic regions have been suggested as important factors in determining the effect of multiple species co-infections. PRINCIPAL
findingsIn order to investigate the impact of multiple-species infections on clinical measures of malaria we carried out a cross-sectional community survey in Malawi, in 2002. We collected clinical and parasitological data from 2918 participants aged >6 months, and applied a questionnaire to measure malaria morbidity. We examined the effect of transmission seasonality and intensity on fever, history of fever, haemoglobin concentration ([Hb]) and parasite density, by comparing three regions: perennial transmission (PT), high intensity seasonal transmission (HIST) and low intensity seasonal transmission (LIST). These regions were defined using multi-level modelling of PCR prevalence data and spatial and geo-climatic measures. The three Plasmodium species (P. falciparum, P. malariae and P. ovale) were randomly distributed amongst all children but not adults in the LIST and PT regions. Mean parasite density in children was lower in the HIST compared with the other two regions. Mixed species infections had lower mean parasite density compared with single species infections in the PT region. Fever rates were similar between transmission regions and were unaffected by mixed species infections. A history of fever was associated with single species infections but only in the HIST region. Reduced mean [Hb] and increased anaemia was associated with perennial transmission compared to seasonal transmission. Children with mixed species infections had higher [Hb] in the HIST region.
conclusionsOur study suggests that the interaction of Plasmodium co-infecting species can have protective effects against some clinical outcomes of malaria but that this is dependent on the seasonality and intensity of malaria transmission.
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