Temporal association of acute hepatitis A and Plasmodium falciparum malaria in children

In sub-Saharan Africa, Plasmodium falciparum and hepatitis A (HAV) infections are common, especially in children. Co-infections with these two pathogens may therefore occur, but it is unknown if temporal clustering exists. We studied the pattern of co-infection of P. falciparum malaria and acute HAV...

Full description

Saved in:
Bibliographic Details
Published in:PloS one 2011-07, Vol.6 (7), p.e21013-e21013
Main Authors: Klein Klouwenberg, Peter, Sasi, Philip, Bashraheil, Mahfudh, Awuondo, Ken, Bonten, Marc, Berkley, James, Marsh, Kevin, Borrmann, Steffen
Format: Article
Language:English
Subjects:
Acute Disease
Anopheles
Blood
Child, Preschool
Children
Clustering
Culicidae
Erythrocytes
Female
Hepatitis
Hepatitis A
Hepatitis A - complications
Hepatitis A - epidemiology
Hepatitis A - immunology
Hepatitis A Antibodies - immunology
Hepatitis A virus
Humans
Immunoglobulin M
Incidence
Infection
Infections
Kenya - epidemiology
Laboratories
Liver diseases
Malaria
Malaria, Falciparum - complications
Malaria, Falciparum - epidemiology
Male
Medical research
Medicine
Mosquitoes
Parasites
Pathogens
Patients
Plasmodium falciparum
Surveillance
Time Factors
Vector-borne diseases
Viruses
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:In sub-Saharan Africa, Plasmodium falciparum and hepatitis A (HAV) infections are common, especially in children. Co-infections with these two pathogens may therefore occur, but it is unknown if temporal clustering exists. We studied the pattern of co-infection of P. falciparum malaria and acute HAV in Kenyan children under the age of 5 years in a cohort of children presenting with uncomplicated P. falciparum malaria. HAV status was determined during a 3-month follow-up period. Among 222 cases of uncomplicated malaria, 10 patients were anti-HAV IgM positive. The incidence of HAV infections during P. falciparum malaria was 1.7 (95% CI 0.81-3.1) infections/person-year while the cumulative incidence of HAV over the 3-month follow-up period was 0.27 (95% CI 0.14-0.50) infections/person-year. Children with or without HAV co-infections had similar mean P. falciparum asexual parasite densities at presentation (31,000/µL vs. 34,000/µL, respectively), largely exceeding the pyrogenic threshold of 2,500 parasites/µL in this population and minimizing risk of over-diagnosis of malaria as an explanation. The observed temporal association between acute HAV and P. falciparum malaria suggests that co-infections of these two hepatotrophic human pathogens may result from changes in host susceptibility. Testing this hypothesis will require larger prospective studies.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0021013