Characterising residual malaria transmission in forested areas with low coverage of core vector control in central Viet Nam
Characterising residual malaria transmission in forested areas with low coverage of core vector control in central Viet Nam
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DOI：
10.1186/s13071-019-3695-1
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发表时间：
2019-09-18
影响因子：
3.2
通讯作者：
Hii, Jeffrey
中科院分区：
文献类型：
--
作者：
Edwards, Hannah Margaret;Vu Duc Chinh;Hii, Jeffrey
背景资料：尽管近年来越南在显著减少疟疾负担方面取得了巨大成功，但偏远森林地区和边缘化群体中疟疾病媒和疟原虫感染的持续存在对实现消除疟疾提出了挑战，并对重新出现传播构成了威胁。尽管据报告长效驱虫蚊帐的覆盖率很高，这是疟疾的主要控制方法，但传播往往在人口中持续存在。为了调查可能造成这种情况的因素，在越南中南部的Son Thai社区进行了一项混合方法研究，尽管普及了长效驱虫蚊帐，但该社区仍有疟疾病例。一个横截面的行为和净覆盖率进行了调查沿着与观察净使用和昆虫学收集在村里，农舍和森林网站使用的社区members of the community.Results：大多数社区成员拥有一个农场小屋阴谋和71.9%的成年人年龄在18岁以上，有时睡在农场小屋过夜，而三分之一睡在森林里。村庄家庭拥有和使用蚊帐的比例很高，但在农舍和森林中则低得多;只有44.4%的人报告经常在农场使用蚊帐，12.1%的人报告经常在森林中使用蚊帐。在该村没有捕获到主要按蚊种，但大劣按蚊（S. L.）（n = 271）和An.斑肌（n = 14）在4.5公里外的农舍和森林中被捕获。大部分的咬伤发生在傍晚时分，人们还没有下到蚊帐里。昆虫接种率（EIR）。dirus（s.l.）分别为17.8和25.3传染性叮咬每人每年在室外农场小屋网站和森林，分别为恶性疟原虫和25.3在森林网站为P. vivax.Conclusions：尽管高净覆盖率的村庄，覆盖率和访问出现在农场小屋和森林的按蚊叮咬和寄生虫传播的风险要大得多的差距。由于自给农作和林业活动是这些社区不可或缺的一部分，因此需要探索新的个人保护方法，以便在这些地区使用，这些方法最好能够与社区接触，是持久的、便携的，并且需要最小的行为改变。
Background: Despite great success in significantly reducing the malaria burden in Viet Nam over recent years, the ongoing presence of malaria vectors and Plasmodium infection in remote forest areas and among marginalised groups presents a challenge to reaching elimination and a threat to re-emergence of transmission. Often transmission persists in a population despite high reported coverage of long-lasting insecticidal nets (LLINs), the mainstay control method for malaria. To investigate what factors may contribute to this, a mixed-methods study was conducted in Son Thai commune, a community in south-central Viet Nam that has ongoing malaria cases despite universal LLIN coverage. A cross-sectional behavioural and net-coverage survey was conducted along with observations of net use and entomological collections in the village, farm huts and forest sites used by members of the community.Results: Most community members owned a farm hut plot and 71.9% of adults aged 18+ years sometimes slept overnight in the farm hut, while one-third slept overnight in the forest. Ownership and use of nets in the village households was high but in the farm huts and forest was much lower; only 44.4% reported regularly using a bednet in the farm and 12.1% in the forest. No primary anopheline species were captured in the village, but Anopheles dirus (s.l.) (n = 271) and An. maculatus (s.l.) (n = 14) were captured as far as 4.5 km away in farm huts and forest. A high proportion of biting was conducted in the early evening before people were under nets. Entomological inoculation rates (EIR) of An. dirus (s.l.) were 17.8 and 25.3 infectious bites per person per year in the outdoor farm hut sites and forest, respectively, for Plasmodium falciparum and 25.3 in the forest sites for P. vivax.Conclusions: Despite high net coverage in the village, gaps in coverage and access appear in the farm huts and forest where risk of anopheline biting and parasite transmission is much greater. Since subsistence farming and forest activities are integral to these communities, new personal protection methods need to be explored for use in these areas that can ideally engage with the community, be durable, portable and require minimal behavioural change.