Ranjha Ritesh, Singh Kuldeep, Baharia Rajendra K, Mohan Mradul, Anvikar Anup R, Bharti Praveen K
ICMR-National Institute of Malaria Research, New Delhi, India.
Academy of Scientific and Innovative Research, Ghaziabad, India.
Glob Pediatr. 2023 Dec;6:None. doi: 10.1016/j.gpeds.2023.100085.
The pediatric population, especially under-five children, is highly susceptible to malaria and accounts for 76 % of global malaria deaths according to the World Malaria Report 2022. The purpose of this manuscript is to discuss the various factors involved in the susceptibility of the pediatric population to Malaria and the importance of this age group for malaria elimination.
Data on pediatric malaria epidemiology that includes prevalence, risk factors, immune factors, socioeconomic factors, control methods, etc. were extracted from published literature using PubMed and Google Scholar. This data was further correlated with malaria incidence data from the World Health Organization (WHO) and the National Center for Vector Borne Diseases Control (NCVBDC).
The younger age group is vulnerable to severe malaria due to an immature immune system. The risk of infection and clinical disease increases after the waning of maternal immunity. In the initial years of life, the developing brain is more susceptible to malaria infection and its after-effects. The pediatric population may act as a malaria transmission reservoir due to parasite density and asymptomatic infections. WHO recommended RTS,S/AS01 has limitations and may not be applicable in all settings to propel malaria elimination.
The diagnosis of malaria is based on clinical suspicion and confirmed with microscopy and/or rapid diagnostic testing. The school-age pediatric population serves as a transmission reservoir in the form of asymptomatic malaria since they have acquired some immunity due to exposure in early childhood. Targeting the hidden reservoir in the pediatric population and protecting this vulnerable group will be essential for malaria elimination from the countries targeting elimination.
儿童群体，尤其是五岁以下儿童，极易感染疟疾，根据《2022年世界疟疾报告》，其占全球疟疾死亡人数的76%。本手稿的目的是探讨儿童群体易感染疟疾的各种因素以及该年龄组对于消除疟疾的重要性。
从使用PubMed和谷歌学术搜索的已发表文献中提取有关儿童疟疾流行病学的数据，包括患病率、危险因素、免疫因素、社会经济因素、控制方法等。该数据进一步与世界卫生组织（WHO）和国家媒介传播疾病控制中心（NCVBDC）的疟疾发病率数据相关联。
由于免疫系统不成熟，较年轻的年龄组易患严重疟疾。母体免疫力减弱后，感染和临床疾病的风险增加。在生命的最初几年，发育中的大脑更容易受到疟疾感染及其后遗症的影响。由于寄生虫密度和无症状感染，儿童群体可能成为疟疾传播的储存宿主。WHO推荐的RTS,S/AS01有局限性，可能并非在所有环境中都适用于推动疟疾消除。
疟疾的诊断基于临床怀疑，并通过显微镜检查和/或快速诊断检测加以确认。学龄儿童群体以无症状疟疾的形式成为传播储存宿主，因为他们在幼儿期接触后已获得了一些免疫力。针对儿童群体中的隐藏储存宿主并保护这一弱势群体对于以消除疟疾为目标的国家消除疟疾至关重要。
