PLoS One [Accessed 25 July 2015]

PLoS One
[Accessed 25 July 2015]

Research Article
School-Age Children Are a Reservoir of Malaria Infection in Malawi
Jenny A. Walldorf, Lauren M. Cohee, Jenna E. Coalson, Andy Bauleni, Kondwani Nkanaunena,
Atupele Kapito-Tembo, Karl B. Seydel, Doreen Ali, Don Mathanga, Terrie E. Taylor, Clarissa alim, Miriam K. Laufer
Published: July 24, 2015
DOI: 10.1371/journal.pone.0134061
Malaria surveillance and interventions in endemic countries often target young children at highest risk of malaria morbidity and mortality. We aimed to determine whether school-age children and adults not captured in surveillance serve as a reservoir for malaria infection and may contribute to malaria transmission. Cross-sectional surveys were conducted in one rainy and one dry season in southern Malawi. Demographic and health information was collected for all household members. Blood samples were obtained for microscopic and PCR identification of Plasmodium falciparum. Among 5796 individuals aged greater than six months, PCR prevalence of malaria infection was 5%, 10%, and 20% in dry, and 9%, 15%, and 32% in rainy seasons in Blantyre, Thyolo, and Chikhwawa, respectively. Over 88% of those infected were asymptomatic. Participants aged 6–15 years were at higher risk of infection (OR=4.8; 95%CI, 4.0–5.8) and asymptomatic infection (OR=4.2; 95%CI, 2.7–6.6) than younger children in all settings. School-age children used bednets less frequently than other age groups. Compared to young children, school-age children were brought less often for treatment and more often to unreliable treatment sources. Conclusion: School-age children represent an underappreciated reservoir of malaria infection and have less exposure to antimalarial interventions. Malaria control and elimination strategies may need to expand to include this age group.

Investigation of a Measles Outbreak in China to Identify Gaps in Vaccination Coverage, Routes of Transmission, and Interventions
Xiang Zheng, Ningjing Zhang, Xiaoshu Zhang, Lixin Hao, Qiru Su, Haijun Wang, Kongyan Meng, Binglin Zhang, Jianfeng Liu, Huaqing Wang, Huiming Luo, Li Li, Hui Li, Chao Ma
Research Article | published 24 Jul 2015 | PLOS ONE 10.1371/journal.pone.0133983

Effect of Restricting Access to Health Care on Health Expenditures among Asylum-Seekers and Refugees: A Quasi-Experimental Study in Germany, 1994–2013
Kayvan Bozorgmehr, Oliver Razum
Research Article | published 22 Jul 2015 | PLOS ONE 10.1371/journal.pone.0131483