Demography, maternal health and the epidemiology of malaria and other major infectious diseases in the rural department Tsamba-Magotsi, Ngounie Province, in central African Gabon
Demography, maternal health and the epidemiology of malaria and other major infectious diseases in the rural department Tsamba-Magotsi, Ngounie Province, in central African Gabon
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DOI：
10.1186/s12889-017-4045-x
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发表时间：
2017-01-28
影响因子：
4.5
通讯作者：
Matsiegui, P. B.
中科院分区：
文献类型：
--
作者：
Manego, R. Zoleko;Mombo-Ngoma, G.;Matsiegui, P. B.
背景：撒哈拉以南非洲正在经历从传染病为主向非传染性疾病和与生活方式有关的疾病的流行病学转变。然而，这种转变的速度和疾病流行病学的模式在富裕的城市和农村贫困人口之间是不平衡的。为了解决加蓬中部非洲热带雨林地区偏远农村地区的这一问题，进行了这项研究，以评估前往卫生保健的原因，并确定察巴马戈茨省疟疾和其他主要传染病的流行病学特征。方法：收集当地医院就诊记录的主要原因。进行了以人口为基础的横断面调查，以评估当地疟疾流行病学。参加产前保健服务的孕妇作为哨点人群进行了调查，以确定社区中慢性病毒和寄生虫感染的特征。结果：2010年，在正规卫生保健部门总共10,580次咨询中，传染病占71%（7469次）。总体而言，疟疾——由临床综合症定义——仍然是就医的最常见原因。一项对840名居住在查巴马戈齐的无症状个体的疟疾横断面调查显示，疟原虫感染率为37%。2-10岁无症状儿童（疟疾流行的标准衡量标准）的感染率为46%（217人中有100人），其中恶性疟原虫为优势种（79%）。与其他疟原虫（卵圆疟原虫和疟疾疟原虫）的感染以合并感染最为常见（23.2%）。在孕妇产前保健访问的横断面评估中，HIV、HBV和梅毒的患病率分别为6.2、7.3和2.5%。泌尿生殖道血吸虫病和丝虫病病原体罗阿罗阿和曼索菌是影响当地人口的高度流行的慢性寄生虫感染。结论：尽管过去十年Tsamba Magotsi的可及性有了重大改善，但在加蓬农村人口的疾病谱上，流行病学转变似乎没有发生重大变化。疟原虫感染的高流行率表明疟疾相关发病率的高负担。传染病仍然是最重要的健康问题之一，热带医学和传染病领域的进一步研究活动可以帮助改善当地人口的保健。
Background: Sub-Saharan Africa is undergoing an epidemiological transition from a predominance of infectious diseases to non-communicable and lifestyle related conditions. However, the pace of this transition and the pattern of disease epidemiology are uneven between affluent urban and rural poor populations. To address this question for a remote rural region located in the central African rainforest region of Gabon, this study was conducted to assess reasons for health care attendance and to characterize the epidemiology of malaria and other major infectious diseases for the department of Tsamba Magotsi.Methods: Major causes for health care attendance were collected from local hospital records. Cross sectional population based surveys were performed for the assessment of local malaria epidemiology. Pregnant women attending antenatal care services were surveyed as a sentinel population for the characterization of chronic viral and parasitic infections in the community.Results: Infectious diseases were responsible for 71% (7469) of a total of 10,580 consultations at the formal health care sector in 2010. Overall, malaria - defined by clinical syndrome - remained the most frequent cause for health care attendance. A cross sectional malaria survey in 840 asymptomatic individuals residing in Tsamba Magotsi resulted in a Plasmodium spp. infection prevalence of 37%. The infection rate in 2-10 year old asymptomatic children - a standard measure for malaria endemicity - was 46% (100 of 217) with P. falciparum as predominant species (79%). Infection with other plasmodial species (P. ovale and P. malariae) presented most commonly as coinfections (23.2%). Prevalence of HIV, HBV, and syphilis were 6.2, 7.3, and 2.5%, respectively, in cross-sectional assessments of antenatal care visits of pregnant women. Urogenital schistosomiasis and the filarial pathogens Loa loa and Mansonella perstans are highly prevalent chronic parasitic infections affecting the local population.Conclusions: Despite major improvements in the accessibility of Tsamba Magotsi over the past decade the epidemiological transition does not appear to have majorly changed on the spectrum of diseases in this rural Gabonese population. The high prevalence of Plasmodium infection indicates a high burden of malaria related morbidity. Infectious diseases remain one of the most important health issues and further research activities in the field of tropical medicine and infectious diseases could help improve health care for the local population.