In a prospective study in Tanzania, Reyburn and colleagues examined
patterns of severe malaria and mortality and the relationship to age in areas
of high, moderate, and low transmission of Plasmodium falciparum to elucidate possible long-term consequences of malaria control efforts
that delay immune acquisition. Increasing odds of severe malarial anemia were
associated with younger age, and increasing odds of cerebral malaria were
associated with older age and residence in areas with low levels of transmission.
Respiratory distress was not associated with age or transmission level. Mortality
curves were J-shaped, with lowest mortality among children 3 to 4 years of