The research analysed over 6000 paediatric hospital admissions from 35 hospitals across each Africa, matching patients to populations where the chances of childhood infection varied from very low to very high. They looked for typical indicators of severe disease in children, including anaemia, cerebral symptoms, and respiratory distress.
The Wellcome-funded study represents the first quantitative analysis of the relationship between community infection risks and admission rates with malaria for over 25 years. The authors report that when transmission is low, fewer than one child in every thousand will need to seek emergency care; this rose to 3-4 children in every thousand under high transmission. By quantifying the rate at which children are hospitalised under different transmission settings, the research allows hospitals to anticipate demand for paediatric emergency care using measures of community parasite exposure.
- If we can reduce malaria transmission by a quarter we can halve the rate of children needing emergency care for severe, life-threatening malaria.
- Supports the current intervention policies - that are focusing on younger children - as the most effective strategy for preventing severe malaria disease.
- Help in understanding and predicting the age-pattern at which children are hospitalised under different settings, so resources can be focused on the children with the highest risk of needing emergency care.
"Across Africa tens of thousands of children are admitted every year to hospital with severe malaria posing a heavy burden on the health system. Our findings support continued our efforts to reduce the infection risks in children under five years of age rather than worrying this would delay the development of immunity" - Dr Alice Kamau from KWTRP
"There have been concerns that with a reduction in malaria transmission through intervention would lead to a delayed immunity, shifting the malaria burden into older age groups. Our data show that the age of severe malaria is shifted to older age groups with declining transmission intensity. Despite this shift to older children in lower transmission settings, the overall severe malaria burden remains very low and severe malaria remains predominantly a problem of children below five years of age" - Professor Bob Snow