THE ASSOCIATION BETWEEN SUBMICROSCOPIC MALARIA INFECTION AND FEVER: FINDINGS FROM A CROSS-SECTIONAL STUDY IN MALAWI
Barrall, Angelica Lynne
Dyer, Typhanye V
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Individuals with submicroscopic malaria infection are an important reservoir for transmission, but the clinical consequences of these low-density parasitemia infections are poorly understood. Using cross-sectional data from six household-based surveys conducted during the dry and rainy seasons in Malawi from 2012 to 2014, this study examined the association between submicroscopic infection and fever in children and adults. For each survey, 900 households were recruited from three distinct ecological settings in southern Malawi to participate in the study (N=22,145). Overall prevalence of submicroscopic infection in the analytic sample was 8.1%. In a generalized linear mixed model accounting for clustering at the household and neighborhood levels and controlling for age and survey number, submicroscopic infection predicted fever in the dry season only (OR=1.66; 95% CI: 1.04, 2.66). Therefore, fever might not be a consistent marker of submicroscopic infection, but identification and treatment of low parasitemia infections is necessary to eliminate malaria transmission.