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The design and statistical power of treatment re-infection studies of the association between pre-erythrocytic immunity and infection with Plasmodium falciparum.
- Source :
- Malaria Journal; 2013, Vol. 12 Issue 1, p1-10, 10p, 1 Chart, 5 Graphs
- Publication Year :
- 2013
-
Abstract
- Background: Understanding the role of pre-erythrocytic immune responses to Plasmodium falciparum parasites is crucial for understanding the epidemiology of malaria. However, published studies have reported inconsistent results on the association between markers of pre-erythrocytic immunity and protection from malaria. Methods: The design and statistical methods of studies of pre-erythrocytic immunity were reviewed, and factors affecting the likelihood of detecting statistically significant associations were assessed. Treatment re-infection studies were simulated to estimate the effects of study size, transmission intensity, and sampling frequency on the statistical power to detect an association between markers of pre-erythrocytic immunity and protection from infection. Results: Nine of nineteen studies reviewed reported statistically significant associations between markers of pre-erythrocytic immunity and protection from infection. Studies with large numbers of participants in high-transmission settings, followed longitudinally with active detection of infection and with immune responses analysed as continuous variables, were most likely to detect statistically significant associations. Simulation of treatment re-infection studies highlights that many studies are underpowered to detect statistically significant associations, providing an explanation for the finding that only some studies report significant associations between pre-erythrocytic immune responses and protection from infection. Conclusions: The findings of the review and model simulations are consistent with the hypothesis that pre-erythrocytic immune responses prevent P. falciparum infections, but that many studies are underpowered to consistently detect this effect. [ABSTRACT FROM AUTHOR]
- Subjects :
- PLASMODIUM falciparum
IMMUNE response
MALARIA
PARASITES
SIMULATION methods & models
Subjects
Details
- Language :
- English
- ISSN :
- 14752875
- Volume :
- 12
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- Malaria Journal
- Publication Type :
- Academic Journal
- Accession number :
- 90280242
- Full Text :
- https://doi.org/10.1186/1475-2875-12-278