In this cohort study, the authors studied the effect of blood malaria parasite density on fever incidence in children in an endemic area with 9 days'follow-up of 1 - to 12-year-old children during two time periods : the end of the dry season (May 1993 : n=783) and the end of the rainy season (October 1993 : n=841) in Bougoula, West Africa (region of Sikasso, Mali).
The cumulative incidence of fever (temperature>38.0°C) was 2.0% in the dry season and 8.2% in the rainy season (p<0.0001).
In the rainy season, the risk of fever was increased in children of ages 1-3 years (relative risk (RR)=2.5,95% confidence interval (CI) 1.6-4.1) ; in those with an initial parasitemia>15,000/mul (RR=2.7,95% CI 1.4-5.4) ; in children with an enlarged spleen (RR=2.0,95% CI 1.2-3.3) ; or in those with anemia (hematocrit<30% : RR=1.8,95% CI 1.1-2.9).
In the dry season, anemia was the only predictor of fever incidence.
In the rainy season, the best predictors of fever were, in order, age (<4 years), enlarged spleen, and high parasite density.
Even in the higher risk groups, the cumulative incidence was<20%. The authors conclude that most children with high parasite density do not develop fever subsequently.
The association between parasite density and fever varies according to age and season. (...)
Mots-clés Pascal : Paludisme, Protozoose, Parasitose, Infection, Epidémiologie, Parasitémie, Fièvre, Enfant, Homme, Endémie, Variation saisonnière, Milieu rural, Mali, Afrique, Age
Mots-clés Pascal anglais : Malaria, Protozoal disease, Parasitosis, Infection, Epidemiology, Parasitemia, Fever, Child, Human, Endemy, Seasonal variation, Rural environment, Mali, Africa, Age
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0315889
Code Inist : 002B05E02B4. Création : 12/09/1997.