Quantification of the Proportion of Unfavorable Clinical Outcomes among Imported Malaria Patients According to the Degree of Semi-Immunity on Population Level: An Ecological Study

The protective effect of semi-immunity to alleviate clinical complications of malaria remains incompletely understood. This ecological study quantified the proportion of unfavorable clinical outcomes among patient populations with imported malaria as a function of the reported proportion of absent semi-immunity in a patient population. Group-level proportions were extracted from published studies on imported malaria. Linear regression analyses demonstrate a consistent positive trend between the average proportion of absent semi-immunity in patient populations of imported malaria and the proportion of unfavorable clinical outcomes therein. Regression equations provide a group-level estimate of attributable fractions of clinical complications resulting from absent semi-immunity to malaria.