Carriage of chloroquine-resistant parasites and delay of effective treatment increase the risk of severe malaria in Gambian children

Larissa Meerman, Rosalynn Ord, J. Teun Bousema, Maarten Van Niekerk, Emelia Osman, Rachel Hallett, Margaret Pinder, Gijs Walraven, Colin J. Sutherland

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Two hundred thirty-four Gambian children with severe falciparum malaria who were admitted to the pediatric ward of a rural district hospital each were matched for age with a same-sex control subject presenting as an outpatient with uncomplicated falciparum malaria. Severe malarial anemia (SMA) was the most common presentation (152 cases), followed by cerebral malaria (38 cases) and hyperparasitemia (26 cases). Children presenting with SMA were significantly younger and more likely to carry gametocytes than were children with other severe presentations. Alleles of the genes pfcrt and pfmdr1 associated with chloroquine-resistant parasites occurred together among cases presenting with SMA alone more often than among their matched controls (odds ratio, 2.08 [95% confidence interval, 1.04-4.38]; P = .039). Costs of travel to the hospital of more than US $0.20, use of mosquito repellents, and carriage of resistant parasites were identified as independent risk factors for severe malaria in the case-control analysis. We conclude that, in this setting, poor access to the hospital and a high prevalence of chloroquine-resistant parasites lead to a delay of adequate treatment for young children with malaria, who may then develop SMA.

Original languageEnglish
Pages (from-to)1651-1657
Number of pages7
JournalJournal of Infectious Diseases
Volume192
Issue number9
DOIs
Publication statusPublished - 1 Nov 2005
Externally publishedYes

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Chloroquine
Malaria
Anemia
Parasites
Falciparum Malaria
Cerebral Malaria
Rural Hospitals
District Hospitals
Therapeutics
Culicidae
Outpatients
Alleles
Odds Ratio
Confidence Intervals
Pediatrics
Costs and Cost Analysis
Genes

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Immunology

Cite this

Carriage of chloroquine-resistant parasites and delay of effective treatment increase the risk of severe malaria in Gambian children. / Meerman, Larissa; Ord, Rosalynn; Bousema, J. Teun; Van Niekerk, Maarten; Osman, Emelia; Hallett, Rachel; Pinder, Margaret; Walraven, Gijs; Sutherland, Colin J.

In: Journal of Infectious Diseases, Vol. 192, No. 9, 01.11.2005, p. 1651-1657.

Research output: Contribution to journalArticle

Meerman, L, Ord, R, Bousema, JT, Van Niekerk, M, Osman, E, Hallett, R, Pinder, M, Walraven, G & Sutherland, CJ 2005, 'Carriage of chloroquine-resistant parasites and delay of effective treatment increase the risk of severe malaria in Gambian children', Journal of Infectious Diseases, vol. 192, no. 9, pp. 1651-1657. https://doi.org/10.1086/496887
Meerman, Larissa ; Ord, Rosalynn ; Bousema, J. Teun ; Van Niekerk, Maarten ; Osman, Emelia ; Hallett, Rachel ; Pinder, Margaret ; Walraven, Gijs ; Sutherland, Colin J. / Carriage of chloroquine-resistant parasites and delay of effective treatment increase the risk of severe malaria in Gambian children. In: Journal of Infectious Diseases. 2005 ; Vol. 192, No. 9. pp. 1651-1657.
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