Please use this identifier to cite or link to this item: http://hdl.handle.net/123456789/4250
Title: Clinical case definitions and malaria vaccine efficacy.
Authors: Rogers, W.O.
Atuguba, F.
Oduro, A.R.
Hodgson, A.
Koram, K.A.
Keywords: EMTREE drug terms: malaria vaccine EMTREE medical terms: article; controlled study; drug efficacy; female; fever; Ghana; human; infant; logistic regression analysis; major clinical study; malaria; male; parasitemia; preschool child; priority journal; treatment outcome
Issue Date: Feb-2006
Citation: Rogers, W. O., Atuguba, F., Oduro, A. R., Hodgson, A., & Koram, K. A. (2006). Clinical case definitions and malaria vaccine efficacy. Journal of Infectious Diseases, 193(3), 467-473.
Abstract: Reported efficacies from vaccine trials may depend heavily on the clinical case definition used in the trial. The dependence may be particularly striking for diseases such as malaria, in which no single case definition is appropriate. We used logistic regression modeling of the relationship between parasitemia and fever in data sets from Ghanaian children to determine the fraction of fevers attributable to malaria and to model how the choice of a threshold parasitemia in the clinical case definition affects the measured efficacy of malaria vaccines. Calculated clinical attack rates varied 10-fold as a function of the threshold parasitemia. Strikingly, measured vaccine efficacies in reducing clinical malaria depended heavily on the threshold parasitemia, varying between 20% and 80% as the threshold varied between 1 and 5000 parasites/μL. We suggest that clinical case definitions of malaria that incorporate a threshold parasitemia are arbitrary and do not yield stable estimates of vaccine trial end points. © 2005 by the Infectious Diseases Society of America. All rights reserved.
URI: http://hdl.handle.net/123456789/4250
ISSN: 00221899
Appears in Collections:Noguchi Memorial Institute for Medical Research

Files in This Item:
There are no files associated with this item.


Items in UGSpace are protected by copyright, with all rights reserved, unless otherwise indicated.