@article{ae30547078f011dd81b0000ea68e967b,
title = "Altitude-dependent and -independent variations in Plasmodium falciparum prevalence in northeastern Tanzania",
abstract = "BACKGROUND: Effective malaria control requires information about intensity of transmission across large areas and populations. Estimates based on entomological factors lack precision and are not cost-effective to obtain. We tested altitude and rainfall measurements as correlates of transmission intensity in different ecological settings. METHODS: We conducted 2 cross-sectional surveys of approximately 12,000 people (1-45 years old) in 6 altitude transects (150-1800 m) in the Kilimanjaro and Tanga regions of Tanzania. Data were analyzed for associations with altitude and rainfall estimates by use of appropriate regression models. RESULTS: Plasmodium falciparum prevalence showed a negative relationship with altitude (19% and 21% decrease/100-m altitude increase, respectively, in children in Kilimanjaro and Tanga) and rainfall during the 3 months before the survey (46% decrease/100-mm rainfall increase in children in Kilimanjaro). Mean hemoglobin concentrations increased with altitude (0.05 and 0.09 g/dL/100-m altitude increase, respectively, in children in Kilimanjaro and Tanga) and rainfall (0.17 g/dL/100-mm rainfall increase in children and adults in Kilimanjaro). DISCUSSION: Altitude and rainfall were correlated with parasite prevalence and mean hemoglobin concentration; however, the relationship varied according to ecological setting. Climatological variables alone cannot predict malarial outcomes. Local variations in seasonality of malaria transmission--together with vector species composition, topography, host and parasite genetics, and socioeconomic factors--may influence malaria prevalence.",
author = "Drakeley, {Chris J} and Ilona Carneiro and Hugh Reyburn and Robert Malima and Lusingu, {John P A} and Jonathan Cox and Theander, {Thor G} and Nkya, {Watoky M M M} and Lemnge, {Martha M} and Riley, {Eleanor M}",
note = "Keywords: Adolescent; Adult; Altitude; Animals; Child; Child, Preschool; Cross-Sectional Studies; Female; Humans; Infant; Malaria, Falciparum; Male; Middle Aged; Rain; Tanzania",
year = "2005",
doi = "10.1086/429669",
language = "English",
volume = "191",
pages = "1589--98",
journal = "Journal of Infectious Diseases",
issn = "0022-1899",
publisher = "Oxford University Press",
number = "10",
}
