In this AL 8810 study, we did not observe cerebral malaria episodes. The incidence of this syndrome is inversely related to malaria transmission intensity [12] and in areas with high levels of transmission, similar to our study site, this clinical presentation is uncommon. Trials to test malaria vaccines that specifically target pathogenic processes related to cerebral malaria would need to be undertaken in areas with moderate or low transmission, where this syndrome represents a higher proportion of severe malaria events. A similar pattern has ![image]()
been observed in areas where falciparum epidemiology is transitioning from high to low transmission intensity [13]: while the total number of malaria-related hospitalizations might remain stable for several years, an increasing proportion of life-threatening malaria presents as cerebral malaria. In low transmission areas, severe malaria incidence peaks at older ages and over a wider age range, and thus vaccine trials would need to recruit older children and likely require a larger sample size or longer follow-up to measure efficacy against cerebral malaria.
been observed in areas where falciparum epidemiology is transitioning from high to low transmission intensity [13]: while the total number of malaria-related hospitalizations might remain stable for several years, an increasing proportion of life-threatening malaria presents as cerebral malaria. In low transmission areas, severe malaria incidence peaks at older ages and over a wider age range, and thus vaccine trials would need to recruit older children and likely require a larger sample size or longer follow-up to measure efficacy against cerebral malaria.