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In clinical trials, the specificity of the disease endpoint is critical to an accurate estimate of vaccine efficacy. We used a logistic regression model to analyse parasite densities among children before and after treatment with antimalarials, in order to estimate the impact that clearing asymptomatic parasitaemia had on the specificity of the endpoint of febrile malaria. The malaria attributable fever fraction was higher after antimalarial treatment (i.e. fever and parasitaemia were more likely to be causally related), implying that drug treatment prior to monitoring decreased the misclassification of febrile malaria. In intervention studies with febrile malaria as an endpoint, clearing asymptomatic parasitaemia increases the study's power more effectively than raising the threshold parasitaemia.

Original publication

DOI

10.1016/j.vaccine.2007.07.057

Type

Journal article

Journal

Vaccine

Publication Date

23/11/2007

Volume

25

Pages

8198 - 8202

Keywords

Antimalarials, Body Temperature, Child, Clinical Trials as Topic, Fever, Humans, Logistic Models, Malaria, Malaria, Falciparum, Parasitemia, Regression Analysis