User:Qpham843/sandbox

This is a sandbox for me to practice editing in. This is bold text. This is italicized text. This is a hyperlink.

---The following is directly copied from the "Holoendemic Wikipedia Page"

A disease is holoendemic when essentially every individual in a population is infected. As the disease is ubiquitous, the young are more likely to express pathogenic responses, whilst the older hosts will carry the disease asymptomatically, or with reduced damage, due to adaptive immunity. Examples of this holoendemic pattern are seen with malaria in areas of sub-saharan Africa (where 75% of the deaths are in children under 5) and trachoma in areas of Saudi Arabia.

---Potential Sources

(Note: This should not be confused with "hyperendemic" which refers to a high prevalence of a disease. Holoendemic specifically refers to the characteristic of symptoms in adults being subdued whereas it is more present in children.)

([1] "In some areas trachoma is holoendemic—every child acquires active trachoma and every adult shows evidence of conjunctival scarring. At any one time, rates of active disease in children range as high as 50%.")

(The below is an excerpt from page 20 of [2], note that this is unfortunately a dissertation)

In the epidemiology of areas of high, all-year-round transmission (holoendemic areas), the clinical pattern of malaria disease shows a markedly different picture. The intense yearly EIR leads to high incidences throughout the year. Almost everyone is repeatedly infected and parasite prevalence is persistently high (Charlwood et al., 1998, Smith et al., 1998). Consequently, populations living in holoendemic areas develop high levels of immunity. Since immunity is progressively acquired with repeated exposure to malaria, the group most at risk of suffering from clinical and severe malaria are children who have not yet contracted many infections and therefore have not yet reached a sufficient level ofimmunity (Marsh, 1993).With increasing age, children who survive gradually develop partial immunity as a result of repeated infections. But only from the age of approximately five years onwards are children significantly immunoprotected against severe malaria attacks (Trape and Rogier, 1996). Illness episodes are not only less frequent, but they also tend to be milder, and rarely progress to complicated or life threatening forms.

([3] The below is a peer-reviewed source [4])

Figure 1 shows that average asymptomatic parasitemia was highest in children from 12 to 23 months of age. From then on, it decreased with age (P < 0.001), first rapidly in children, then slowly in adults, as is classically observed in areas of malaria holoendemicity.'9 Table 1 shows that the risk of fever considerably increased with parasitemia (P < 0.001). The risk of fever decreased with age (Table 2). There was no difference of fever risk or modifier effect due to gender.

---Potential Edits

A disease is considered holoendemic if a {vast majority} of individuals in a population are infected and the pathogenic responses of individuals decreases with age {Source 1}. This is in contrast to a hyperendemic disease, in which the population is equally affected by the disease. In an affected population, the young are more susceptible to the effects of the disease whereas the older hosts have developed an adaptive immunity to them and display pathogenic responses at a lower frequency. Examples of this holoendemic pattern are seen with malaria in areas of sub-saharan Africa and trachoma in areas of Saudi Arabia.

(Remove the RBM factsheet and the WrongDiagnosis website from the references) (Insert {Source 1} and {Source 2} as references)

One of the most well-known cases of holoendicimity is malaria in sub-saharan Africa, in which... Other examples include, but are not limited to trachoma in Saudi Arabia and hepatitis A and B in multiple areas around the world.

http://www.sciencedirect.com/topics/medicine-and-dentistry/holoendemic

---Other Group Edits

A disease is holoendemic when essentially every individual in a population is infected.[1] Although the infection is ubiquitous, symptoms of disease do not appear equally across age groups. The young are more likely to express pathogenic responses, whilst the older hosts will carry the disease asymptomatically, or with reduced damage, due to adaptive immunity.[2][3] ({1} Therefore, holoendemic diseases differ from hyperendemic diseases, whose symptoms are expressed equally by members across age groups of a population.

(Would recommend, "This is in contrast to hyperendemic diseases, in which case symptoms...")