Malaria prevalence, risk factors and spatial distribution in a hilly forest area of Bangladesh.
Malaria prevalence, risk factors and spatial distribution in a hilly forest area of Bangladesh.
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孟加拉国丘陵森林地区的疟疾患病率，危险因素和空间分布。
DOI：
10.1371/journal.pone.0018908
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发表时间：
2011-04-21
期刊：
影响因子：
3.7
通讯作者：
Glass GE
中科院分区：
文献类型：
--
作者：
Haque U;Sunahara T;Hashizume M;Shields T;Yamamoto T;Haque R;Glass GE
疟疾是孟加拉国的一个主要公共卫生问题，在吉大港山区高度流行，2007 年患病率为 11.7%。拉贾斯塔利一个分区的患病率为 36%。 2007 年初采取了多项干预措施来控制疟疾。这项研究的目的是评估这些强化早期干预措施对孟加拉国疟疾的影响。这项流行率研究评估了疟疾高流行率是否仍然存在，如果是，哪些地区和个人仍然处于高感染风险。采用两阶段整群抽样技术对拉贾斯坦利 5,322 个家庭中的 1,400 个家庭（26.3%）进行了抽样，并使用快速诊断测试 (Falci-vax) 进行了筛查。疟疾总体患病率为 11.5%。恶性疟原虫、间日疟原虫感染比例分别为93.2%、1.9%和5.0%。分别进行单变量、多变量逻辑回归和空间聚类分析。性别、年龄、蚊帐数量、森林覆盖率、海拔和家庭密度是潜在的危险因素。确定了具有统计学意义的疟疾群。聚集区和非聚集区之间的危险因素存在显着差异。干预计划实施后两年内，疟疾明显减少。物理和社会环境以及人口特征都与风险的空间异质性相关。识别和定位这些区域的能力为干预计划的初始阶段提供了有针对性的干预策略。然而，在高风险的传播集群中，即使当前计划的广泛覆盖也会导致传播水平降低。这表明需要继续制定新的识别和治疗策略，并提高对寄生虫血症的模式和决定因素的了解。
Malaria is a major public health concern in Bangladesh and it is highly endemic in the Chittagong Hill Tracts where prevalence was 11.7% in 2007. One sub-district, Rajasthali, had a prevalence of 36%. Several interventions were introduced in early 2007 to control malaria. This study was undertaken to evaluate the impacts of these intensive early stage interventions on malaria in Bangladesh. This prevalence study assesses whether or not high malaria prevalence remains, and if so, which areas and individuals remain at high risk of infection. A 2-stage cluster sampling technique was used to sample 1,400 of 5,322 (26.3%) households in Rajasthali, and screened using a rapid diagnostic test (Falci-vax). Overall malaria prevalence was 11.5%. The proportions of Plasmodium falciparum, Plasmodium vivax and infection with both species were 93.2%, 1.9% and 5.0%, respectively. Univariate, multivariate logistic regression, and spatial cluster analyses were performed separately. Sex, age, number of bed nets, forest cover, altitude and household density were potential risk factors. A statistically significant malaria cluster was identified. Significant differences among risk factors were observed between cluster and non-cluster areas. Malaria has significantly decreased within 2 years after onset of intervention program. Both aspects of the physical and social environment, as well as demographic characteristics are associated with spatial heterogeneity of risk. The ability to identify and locate these areas provides a strategy for targeting interventions during initial stages of intervention programs. However, in high risk clusters of transmission, even extensive coverage by current programs leaves transmission ongoing at reduced levels. This indicates the need for continued development of new strategies for identification and treatment as well as improved understanding of the patterns and determinants of parasitaemia.
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影响因子：
3.7
作者：
Haque, Ubydul;Ahmed, Syed Masud;Haque, Rashidul
通讯作者：
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Alam MS;Khan MG;Chaudhury N;Deloer S;Nazib F;Bangali AM;Haque R
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影响因子：
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作者：
Haque U;Hashizume M;Sunahara T;Hossain S;Ahmed SM;Haque R;Yamamoto T;Glass GE
通讯作者：
Glass GE