Imperial College London
Alternate

ProfessorKathMaitland

Faculty of Medicine, Department of Surgery & Cancer

Professor of Tropical Paediatric Infectious Disease
 
 
 
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Contact

 

k.maitland CV

 
 
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Location

 

Based full-time at KEMRI/Wellcome Programme, KenyaQueen Elizabeth and Queen Mary HospitalSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Njuguna:2019:10.1186/s12916-019-1359-9,
author = {Njuguna, P and Maitland, K and Nyaguara, A and Mwanga, D and Mogeni, P and Mturi, N and Mohammed, S and Mwambingu, G and Ngetsa, C and Awuondo, K and Lowe, B and Adetifa, I and Scott, JAG and Williams, TN and Atkinson, S and Osier, F and Snow, RW and Marsh, K and Tsofa, B and Peshu, N and Hamaluba, M and Berkley, JA and Newton, CRJ and Fondo, J and Omar, A and Bejon, P},
doi = {10.1186/s12916-019-1359-9},
journal = {BMC Medicine},
title = {Observational study: 27 years of severe malaria surveillance in Kilifi, Kenya},
url = {http://dx.doi.org/10.1186/s12916-019-1359-9},
volume = {17},
year = {2019}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: Many parts of Africa have witnessed reductions in Plasmodium falciparum transmission over the last 15 years. Since immunity to malaria is acquired more rapidly at higher transmission, the slower acquisition of immunity at lower transmission may partially offset the benefits of reductions in transmission. We examined the clinical spectrum of disease and predictors of mortality after sustained changes in transmission intensity, using data collected from 1989 to 2016. METHODS: We conducted a temporal observational analysis of 18,000 children, aged 14 days to 14 years old, who were admitted to Kilifi County Hospital, Kenya, from 1989 to 2016 with malaria. We describe the trends over time of the clinical and laboratory criteria for severe malaria and associated risk of mortality. RESULTS: During the time periods 1989-2003, 2004-2008, and 2009-2016, Kilifi County Hospital admitted averages of 657, 310, and 174 cases of severe malaria per year including averages of 48, 14, and 12 malaria-associated deaths per year, respectively. The median ages in years of children admitted with cerebral malaria, severe anaemia, and malaria-associated mortality were 3.0 (95% confidence interval (CI) 2.2-3.9), 1.1 (95% CI 0.9-1.4), and 1.1 (95% CI 0.3-2.2) in the year 1989, rising to 4.9 (95% CI 3.9-5.9), 3.8 (95% CI 2.5-7.1), and 5 (95% CI 3.3-6.3) in the year 2016. The ratio of children with cerebral malaria to severe anaemia rose from 1:2 before 2004 to 3:2 after 2009. Hyperparasitaemia was a risk factor for death after 2009 but not in earlier time periods. CONCLUSION: Despite the evidence of slower acquisition of immunity, continued reductions in the numbers of cases of severe malaria resulted in lower overall mortality. Our temporal data are limited to a single site, albeit potentially applicable to a secular trend present in many parts of Africa.
AU  - Njuguna,P
AU  - Maitland,K
AU  - Nyaguara,A
AU  - Mwanga,D
AU  - Mogeni,P
AU  - Mturi,N
AU  - Mohammed,S
AU  - Mwambingu,G
AU  - Ngetsa,C
AU  - Awuondo,K
AU  - Lowe,B
AU  - Adetifa,I
AU  - Scott,JAG
AU  - Williams,TN
AU  - Atkinson,S
AU  - Osier,F
AU  - Snow,RW
AU  - Marsh,K
AU  - Tsofa,B
AU  - Peshu,N
AU  - Hamaluba,M
AU  - Berkley,JA
AU  - Newton,CRJ
AU  - Fondo,J
AU  - Omar,A
AU  - Bejon,P
DO  - 10.1186/s12916-019-1359-9
PY  - 2019///
SN  - 1741-7015
TI  - Observational study: 27 years of severe malaria surveillance in Kilifi, Kenya
T2  - BMC Medicine
UR  - http://dx.doi.org/10.1186/s12916-019-1359-9
UR  - https://www.ncbi.nlm.nih.gov/pubmed/31280724
UR  - http://hdl.handle.net/10044/1/72273
VL  - 17
ER  -
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