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MODELING THE RELATIONSHIP BETWEEN THE POPULATION PREVALENCE OF PLASMODIUM FALCIPARUM MALARIA AND ANEMIA

More than half of all young children and pregnant women are affected by anemia. Although its etiology is multi-factorial, malaria is likely to be a major contributor to chronic anemia in endemic areas. Recent reviews have examined the effect of community-based malaria control interventions on anemia. We analyze how the prevalence of anemia depends on that of Plasmodium falciparum malaria by developing models of the excess risk of anemia caused by malaria at a population level in 24 villages in northeastern Tanzania. In that setting, we estimated that the prevalence of a hemoglobin level < 8 g/dL attributable to malaria was 4.6% in infants, 4.1% in children one year of age, 2.7% in children two years of age, and 3.3% in women of childbearing age. Successful validation of our models in other malaria-endemic settings would enable their use for predicting the impact of malaria control interventions on anemia, and for long-term monitoring and surveillance of malaria.

Received September 18, 2005. Accepted for publication February 8, 2006.

Acknowledgments: This report is a product of the Joint Malaria Programme (JMP), a collaboration between the Tanzanian National Institute for Medical Research, Kilimanjaro Christian Medical School, the London School of Hygiene and Tropical Medicine, and the Centre for Medical Parasitology, University of Copenhagen, and the project "Mathematical modeling of the impact of malaria vaccines on the clinical epidemiology and natural history of Plasmodium falciparum malaria." We thank Amanda Ross for editorial support.

Financial support: The JMP was supported by the United Kingdom Medical Research Council and the Danish International Development Agency. Ilona A. Carniero is supported by the Department for International Development (United Kingdom). Chris J. Drakeley is supported by a Wellcome Trust Research Training Fellowship. The contributions of Thomas Smith and Jürg Utzinger were supported by the Program for Appropriate Technology in Health (PATH) Malaria Vaccine Initiative and GlaxoSmithKline Biologicals S.A.

Disclaimer: Publication of this report and the contents hereof do not necessarily reflect the endorsement, opinion, or viewpoints of the PATH Malaria Vaccine Initiative or GlaxoSmithKline Biologicals S.A.

^* Address correspondence to Ilona A. Carneiro, Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, London, United Kingdom. E-mail: ilona.carneiro{at}lshtm.ac.uk

Authors’ addresses: Ilona A. Carneiro, Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, London, United Kingdom, Telephone: 44-207-927-2686, Fax: 44-207-580-9075, E-mail: ilona.carneiro{at}lshtm.ac.uk. Thomas Smith and Jürg Utzinger, Swiss Tropical Institute, Socinstrasse 57, Postfach, CH-4002, Basel, Switzerland, Telephone: 41-61-284-8273, Fax: 41-61-284-8105, E-mails: Thomas-A.Smith{at}unibas.ch and juerg.utzinger{at}unibas.ch. John P. A. Lusingu and Robert Malima, National Institute for Medical Research, Amani Medical Research Centre, PO Box 4, Amani, Tanzania, Telephone: 255-27-264-0303, Fax: 255-27-264-3869, E-mails: jpalusingu{at}yahoo.co.uk and r_malima{at}hotmail.com. Chris J. Drakeley, Joint Malaria Programme, PO Box 2228, Moshi, Tanzania, Telephone: 255-27-275-3714, Fax: 255-27-275-3982, E-mail: chris.drakeley{at}lshtm.ac.uk.

Reprint requests: Ilona A. Carneiro, Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, London, United Kingdom.

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