{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T03:23:38Z","timestamp":1768879418998,"version":"3.49.0"},"reference-count":60,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,1,9]]},"abstract":"<jats:p>The burden of <jats:italic>Plasmodium falciparum<\/jats:italic> (<jats:italic>Pf<\/jats:italic>) malaria in Kenya is decreasing; however, it is still one of the top 10 causes of morbidity, particularly in regions of western Kenya. Between April 2015 and June 2016, we enrolled 965 apparently healthy children aged 0\u201315 years in former Nyanza and Western Provinces in Kenya to characterize the demographic, geographic, and household risk factors of asymptomatic malaria as part of an epidemiologic study to investigate the risk factors for endemic Burkitt lymphoma. The children were sampled using a stratified, multistage cluster sampling survey design. Malaria was assessed by rapid diagnostic test (RDT) and thick-film microscopy (TFM). Primary analyses of <jats:italic>Pf<\/jats:italic> malaria prevalence (pfPR) are based on RDT. Associations between weighted pfPR and potential risk factors were evaluated using logistic regression, accounting for the survey design. <jats:italic>Plasmodium falciparum<\/jats:italic> malaria prevalence was 36.0% (27.5%, 44.5%) by RDT and 22.3% (16.0%, 28.6%) by TFM. <jats:italic>Plasmodium falciparum<\/jats:italic> malaria prevalence was positively associated with living in the lake-endemic area (adjusted odds ratio [aOR] 3.46; 95% confidence interval [95% CI] 1.63, 7.37), paternal occupation as peasant farmer (aOR 1.87; 1.08, 3.26) or manual laborer (aOR 1.83; 1.00, 3.37), and keeping dogs (aOR 1.62; 0.98\u20132.69) or cows (aOR 1.52; 0.96\u20132.40) inside or near the household. <jats:italic>Plasmodium falciparum<\/jats:italic> malaria prevalence was inversely associated with indoor residual insecticide spraying (IRS) (aOR 0.44; 0.19, 1.01), having a household connected to electricity (aOR 0.47; 0.22, 0.98), and a household with two (aOR 0.45; 0.22, 0.93) or \u2265 three rooms (aOR 0.41; 0.18, 0.93). We report high but geographically heterogeneous pfPR in children in western Kenya and significant associations with IRS and household-level socioeconomic factors.<\/jats:p>","DOI":"10.4269\/ajtmh.18-0481","type":"journal-article","created":{"date-parts":[[2018,11,20]],"date-time":"2018-11-20T07:13:45Z","timestamp":1542698025000},"page":"54-65","source":"Crossref","is-referenced-by-count":12,"title":["A Cross-Sectional Population Study of Geographic, Age-Specific, and Household Risk Factors for Asymptomatic Plasmodium falciparum Malaria Infection in Western Kenya"],"prefix":"10.4269","volume":"100","author":[{"given":"Sally","family":"Peprah","sequence":"first","affiliation":[{"name":"Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Constance","family":"Tenge","sequence":"additional","affiliation":[{"name":"Moi University College of Health Sciences, Eldoret, Kenya;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isaiah O.","family":"Genga","sequence":"additional","affiliation":[{"name":"EMBLEM Study, Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mediatrix","family":"Mumia","sequence":"additional","affiliation":[{"name":"EMBLEM Study, Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pamela A.","family":"Were","sequence":"additional","affiliation":[{"name":"EMBLEM Study, Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert T.","family":"Kuremu","sequence":"additional","affiliation":[{"name":"Moi University College of Health Sciences, Eldoret, Kenya;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walter N.","family":"Wekesa","sequence":"additional","affiliation":[{"name":"Moi University College of Health Sciences, Eldoret, Kenya;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter O.","family":"Sumba","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute, Kisumu, Kenya;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tobias","family":"Kinyera","sequence":"additional","affiliation":[{"name":"EMBLEM Study, African Field Epidemiology Network, Kampala, Uganda;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isaac","family":"Otim","sequence":"additional","affiliation":[{"name":"EMBLEM Study, African Field Epidemiology Network, Kampala, Uganda;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ismail D.","family":"Legason","sequence":"additional","affiliation":[{"name":"EMBLEM Study, African Field Epidemiology Network, Kampala, Uganda;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua","family":"Biddle","sequence":"additional","affiliation":[{"name":"Stanford Hospitals and Clinics, University of Stanford, Pao Alto, California;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven J.","family":"Reynolds","sequence":"additional","affiliation":[{"name":"National Institutes of Health\/Uganda Project Entebbe, National Institute of Allergy and Infectious Diseases, Rockville, Maryland;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ambrose O.","family":"Talisuna","sequence":"additional","affiliation":[{"name":"World Health Organization, Regional Office for Africa, Brazzaville, Congo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert J.","family":"Biggar","sequence":"additional","affiliation":[{"name":"Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kishor","family":"Bhatia","sequence":"additional","affiliation":[{"name":"Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James J.","family":"Goedert","sequence":"additional","affiliation":[{"name":"Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruth M.","family":"Pfeiffer","sequence":"additional","affiliation":[{"name":"Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sam M.","family":"Mbulaiteye","sequence":"additional","affiliation":[{"name":"Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Lancet","first-page":"723","article-title":"Malaria","volume":"383","author":"White","year":"2014"},{"key":"b2","author":"World Health Organization","year":"2017"},{"key":"b3","series-title":"Nature","first-page":"515","article-title":"The prevalence of Plasmodium falciparum in sub-Saharan Africa since 1900","volume":"550","author":"Snow","year":"2017"},{"key":"b4","author":"Kenya National Bureau of Statistics","year":"2015"},{"key":"b5","series-title":"BMC Infect Dis","first-page":"180","article-title":"The risks of malaria infection in Kenya in 2009","volume":"9","author":"Noor","year":"2009"},{"key":"b6","author":"National Malaria Control Programme","year":"2015"},{"key":"b7","series-title":"Nat Commun","first-page":"1133","article-title":"Examining the human infectious reservoir for Plasmodium falciparum malaria in areas of differing transmission intensity","volume":"8","author":"Goncalves","year":"2017"},{"key":"b8","series-title":"Expert Rev Anti Infect Ther","first-page":"623","article-title":"The silent threat: asymptomatic parasitemia and malaria transmission","volume":"11","author":"Lindblade","year":"2013"},{"key":"b9","series-title":"Trends Parasitol","first-page":"296","article-title":"Malaria parasites in the asymptomatic: looking for the hay in the Haystack","volume":"32","author":"Galatas","year":"2016"},{"key":"b10","series-title":"PLoS One","first-page":"e0134061","article-title":"School-age children are a reservoir of malaria infection in Malawi","volume":"10","author":"Walldorf","year":"2015"},{"key":"b11","series-title":"Malar J","first-page":"421","article-title":"Assessment of submicroscopic infections and gametocyte carriage of Plasmodium falciparum during peak malaria transmission season in a community-based cross-sectional survey in western Kenya, 2012","volume":"15","author":"Zhou","year":"2016"},{"key":"b12","series-title":"Malar J","first-page":"527","article-title":"High prevalence of Plasmodium falciparum gametocyte infections in school-age children using molecular detection: patterns and predictors of risk from a cross-sectional study in southern Malawi","volume":"15","author":"Coalson","year":"2016"},{"key":"b13","series-title":"Proc Natl Acad Sci USA","first-page":"E4209","article-title":"Plasmodium-associated changes in human odor attract mosquitoes","volume":"115","author":"Robinson","year":"2018"},{"key":"b14","series-title":"Science","first-page":"267","article-title":"Quantifying the impact of human mobility on malaria","volume":"338","author":"Wesolowski","year":"2012"},{"key":"b15","series-title":"Sci Rep","first-page":"647","article-title":"Dynamic malaria hotspots in an open cohort in western Kenya","volume":"8","author":"Platt","year":"2018"},{"key":"b16","series-title":"PLoS Med","first-page":"e1002452","article-title":"malERA: an updated research agenda for characterising the reservoir and measuring transmission in malaria elimination and eradication","volume":"14","author":"The malERA Refresh Consultative Panel on Characterising the Reservoir and Measuring Transmission","year":"2017"},{"key":"b17","series-title":"EBioMedicine","first-page":"58","article-title":"Evaluating the causal link between malaria infection and endemic Burkitt lymphoma in northern Uganda: a mendelian randomization study","volume":"25","author":"Legason","year":"2017"},{"key":"b18","series-title":"Malar J","first-page":"78","article-title":"Malaria hotspot areas in a highland Kenya site are consistent in epidemic and non-epidemic years and are associated with ecological factors","volume":"5","author":"Ernst","year":"2006"},{"key":"b19","series-title":"PLoS Med","first-page":"e1001256","article-title":"Risk factors for death among children less than 5 years old hospitalized with diarrhea in rural western Kenya, 2005\u20132007: a cohort study","volume":"9","author":"O\u2019Reilly","year":"2012"},{"key":"b20","series-title":"Malar J","first-page":"429","article-title":"High-resolution melting analysis reveals low Plasmodium parasitaemia infections among microscopically negative febrile patients in western Kenya","volume":"13","author":"Kipanga","year":"2014"},{"key":"b21","series-title":"Malar J","first-page":"157","article-title":"Plasmodium falciparum parasitaemia and clinical malaria among school children living in a high transmission setting in western Kenya","volume":"15","author":"Kepha","year":"2016"},{"key":"b22","series-title":"PLoS One","first-page":"e77641","article-title":"Reliability of school surveys in estimating geographic variation in malaria transmission in the western Kenyan highlands","volume":"8","author":"Stevenson","year":"2013"},{"key":"b23","series-title":"Infect Agent Cancer","first-page":"32","article-title":"Burkitt lymphoma research in east Africa: highlights from the 9(th) African organization for research and training in cancer conference held in Durban, South Africa in 2013","volume":"9","author":"Simbiri","year":"2014"},{"key":"b24","series-title":"J Med Entomol","first-page":"833","article-title":"The effects of climatic factors on the distribution and abundance of malaria vectors in Kenya","volume":"39","author":"Minakawa","year":"2002"},{"key":"b25","series-title":"Malar J","first-page":"124","article-title":"Age and geographic patterns of Plasmodium falciparum malaria infection in a representative sample of children living in Burkitt lymphoma-endemic areas of northern Uganda","volume":"16","author":"Maziarz","year":"2017"},{"key":"b26","author":"Kenya National Bureau of Statistics","year":"2013"},{"key":"b27","author":"World Health Organization","year":"2015"},{"key":"b28","series-title":"Lancet Infect Dis","first-page":"582","article-title":"The reliability of diagnostic techniques in the diagnosis and management of malaria in the absence of a gold standard","volume":"6","author":"Ochola","year":"2006"},{"key":"b29","series-title":"Am J Trop Med Hyg","first-page":"119","article-title":"A review of malaria diagnostic tools: microscopy and rapid diagnostic test (RDT)","volume":"77","author":"Wongsrichanalai","year":"2007"},{"key":"b30","series-title":"Bull World Health Organ","first-page":"47","article-title":"A rapid dipstick antigen capture assay for the diagnosis of falciparum malaria. WHO informal consultation on recent advances in diagnostic techniques and vaccines for malaria","volume":"74","author":"World Health Organization Informal Consultation on Recent Advances in Diagnostic Techniques and Vaccines for Malaria","year":"1996"},{"key":"b31","series-title":"Lancet","first-page":"564","article-title":"Diagnosis of malaria by detection of Plasmodium falciparum HRP-2 antigen with a rapid dipstick antigen-capture assay","volume":"343","author":"Beadle","year":"1994"},{"key":"b32","series-title":"Trans R Soc Trop Med Hyg","first-page":"179","article-title":"Persistence of Plasmodium falciparum HRP-2 in successfully treated acute falciparum malaria","volume":"95","author":"Mayxay","year":"2001"},{"key":"b33","series-title":"Parasitol Today","first-page":"439","article-title":"What is clinical malaria? Finding case definitions for field research in highly endemic areas","volume":"10","author":"Schellenberg","year":"1994"},{"key":"b34","series-title":"Int J Cancer","first-page":"121","article-title":"Spatial clustering of endemic Burkitt\u2019s lymphoma in high-risk regions of Kenya","volume":"120","author":"Rainey","year":"2007"},{"key":"b35","series-title":"Int J Cancer","first-page":"1","article-title":"Burkitt\u2019s lymphoma and malaria","volume":"6","author":"Kafuko","year":"1970"},{"key":"b36","series-title":"IARC Sci Publ","first-page":"177","article-title":"Epidemiological evidence for the role of falciparum malaria in the pathogenesis of Burkitt\u2019s lymphoma","volume":"60","author":"Morrow","year":"1985"},{"key":"b37","series-title":"Am J Trop Med Hyg","first-page":"397","article-title":"African Burkitt lymphoma: age-specific risk and correlations with malaria biomarkers","volume":"84","author":"Emmanuel","year":"2011"},{"key":"b38","series-title":"Int J Cancer","first-page":"1231","article-title":"Factors influencing survival among Kenyan children diagnosed with endemic Burkitt lymphoma between 2003 and 2011: a historical cohort study","volume":"139","author":"Buckle","year":"2016"},{"key":"b39","series-title":"J Infect Dis","first-page":"1072","article-title":"Quantifying heterogeneous malaria exposure and clinical protection in a cohort of Ugandan children","volume":"214","author":"Rodriguez-Barraquer","year":"2016"},{"key":"b40","series-title":"Sci Rep","first-page":"3741","article-title":"Relationship between Plasmodium falciparum malaria prevalence, genetic diversity and endemic Burkitt lymphoma in Malawi","volume":"4","author":"Johnston","year":"2014"},{"key":"b41","series-title":"PLoS Med","first-page":"e255","article-title":"Increasing coverage and decreasing inequity in insecticide-treated bed net use among rural Kenyan children","volume":"4","author":"Noor","year":"2007"},{"key":"b42","series-title":"Bull World Health Organ","first-page":"655","article-title":"Integrated malaria vector control with microbial larvicides and insecticide-treated nets in western Kenya: a controlled trial","volume":"87","author":"Fillinger","year":"2009"},{"key":"b43","series-title":"PLoS One","first-page":"e0145282","article-title":"The effect of indoor residual spraying on the prevalence of malaria parasite infection, clinical malaria and anemia in an area of perennial transmission and moderate coverage of insecticide treated nets in western Kenya","volume":"11","author":"Gimnig","year":"2016"},{"key":"b44","series-title":"Am J Trop Med Hyg","first-page":"855","article-title":"The effect of indoor residual spraying on malaria and anemia in a high-transmission area of northern Uganda","volume":"88","author":"Steinhardt","year":"2013"},{"key":"b45","series-title":"Lancet Planet Health","first-page":"e83","article-title":"Rapid improvements to rural Ugandan housing and their association with malaria from intense to reduced transmission: a cohort study","volume":"2","author":"Rek","year":"2018"},{"key":"b46","series-title":"Infect Dis Poverty","first-page":"2","article-title":"Spatial distribution and habitat characterization of mosquito species during the dry season along the Mara River and its tributaries, in Kenya and Tanzania","volume":"7","author":"Dida","year":"2018"},{"key":"b47","series-title":"Am J Trop Med Hyg","first-page":"29","article-title":"Spatial relationship between adult malaria vector abundance and environmental factors in western Kenya highlands","volume":"77","author":"Zhou","year":"2007"},{"key":"b48","series-title":"PLoS Negl Trop Dis","first-page":"e2768","article-title":"Dispersal of adult Culex mosquitoes in an urban west Nile virus hotspot: a mark-capture study incorporating stable isotope enrichment of natural larval habitats","volume":"8","author":"Hamer","year":"2014"},{"key":"b49","series-title":"Am J Trop Med Hyg","first-page":"101","article-title":"Plasmodium coatneyi: observations on periodicity, mosquito infection, and transmission to Macaca mulatta monkeys","volume":"64","author":"Collins","year":"2001"},{"key":"b50","series-title":"Malar J","first-page":"313","article-title":"A systematic, realist review of zooprophylaxis for malaria control","volume":"14","author":"Donnelly","year":"2015"},{"key":"b51","series-title":"J Vector Borne Dis","first-page":"184","article-title":"Effects of long-lasting insecticidal nets and zooprophylaxis on mosquito feeding behaviour and density in Mwea, central Kenya","volume":"46","author":"Kaburi","year":"2009"},{"key":"b52","series-title":"Med Vet Entomol","first-page":"337","article-title":"Effectiveness of zooprophylaxis in malaria control: a theoretical inquiry, with a model for mosquito populations with two bloodmeal hosts","volume":"3","author":"Sota","year":"1989"},{"key":"b53","series-title":"Trans R Soc Trop Med Hyg","first-page":"351","article-title":"Failure of passive zooprophylaxis: cattle ownership in Pakistan is associated with a higher prevalence of malaria","volume":"89","author":"Bouma","year":"1995"},{"key":"b54","series-title":"Parasit Vectors","first-page":"52","article-title":"Push by a net, pull by a cow: can zooprophylaxis enhance the impact of insecticide treated bed nets on malaria control?","volume":"7","author":"Iwashita","year":"2014"},{"key":"b55","series-title":"Malar J","first-page":"591","article-title":"A national health facility survey of malaria infection among febrile patients in Kenya, 2014","volume":"15","author":"Githinji","year":"2016"},{"key":"b56","series-title":"Malar J","first-page":"231","article-title":"The use of schools for malaria surveillance and programme evaluation in Africa","volume":"8","author":"Brooker","year":"2009"},{"key":"b57","series-title":"Malar J","first-page":"121","article-title":"Plasmodium falciparum transmission and aridity: a Kenyan experience from the dry lands of Baringo and its implications for Anopheles arabiensis control","volume":"10","author":"Mala","year":"2011"},{"key":"b58","series-title":"J Theor Biol","first-page":"299","article-title":"The dilution effect of the domestic animal population on the transmission of P. vivax malaria","volume":"266","author":"Nah","year":"2010"},{"key":"b59","series-title":"Clin Infect Dis","first-page":"509","article-title":"Longitudinal outcomes in a cohort of Ugandan children randomized to artemether-lumefantrine versus dihydroartemisinin-piperaquine for the treatment of malaria","volume":"59","author":"Wanzira","year":"2014"},{"key":"b60","series-title":"Malar J","first-page":"250","article-title":"Mosquito nets in a rural area of western Kenya: ownership, use and quality","volume":"9","author":"Githinji","year":"2010"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/100\/1\/article-p54.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/100\/1\/article-p54.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/100\/1\/article-p54.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T12:31:00Z","timestamp":1722429060000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/100\/1\/article-p54.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1,9]]},"references-count":60,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.18-0481","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,1,9]]}}}