Proximity of Residence to Irrigation Determines Malaria Risk and Anopheles Abundance at an Irrigated Agroecosystem in Malawi.
Proximity of Residence to Irrigation Determines Malaria Risk and Anopheles Abundance at an Irrigated Agroecosystem in Malawi.
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居住地与灌溉的接近程度决定了马拉维灌溉农业生态系统中疟疾和疟疾的风险。
DOI：
10.4269/ajtmh.21-0390
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发表时间：
2021-10-18
期刊：
影响因子：
--
通讯作者：
Walker E
中科院分区：
文献类型：
--
作者：
Mangani C;Frake AN;Chipula G;Mkwaila W;Kakota T;Mambo I;Chim'gonda J;Mathanga D;Mzilahowa T;Zulu L;Walker E
随着撒哈拉以南非洲国家扩大灌溉以改善粮食安全和促进经济增长，重要的是量化与这一过程相关的疟疾风险。灌溉生态系统可能与疟疾风险增加有关，但这种关系尚未完全了解。我们在马拉维的Bwanje山谷灌溉计划(800公顷)中研究了这种关系。2016年和2017年的两项横断面研究量化了疟疾的家庭流行率和室内按蚊密度(1,091户5,829名居民)。用多水平Logistic回归估计距灌溉系统的距离与疟疾感染和蚊子密度之间的关系。以富含组氨酸蛋白2为基础的疟疾快速诊断试验的疟疾感染率为50.2%(2765/5511)，镜检法为30.1%(1626/5403)。居住在该计划3 公里以内的家庭的个人的感染率显著较高(调整后的优势比[ = ]1.41；95%可信区间[CI]1.18，1.68)；学龄儿童的感染率在各年龄组中最高(AOR = 1.34；95%CI 1.11，1.63)。报告使用蚊帐的个人，以及社会经济地位较高、户主或配偶受教育程度较高的家庭，感染疟疾的几率较低。雌性按蚊(总计2,215只；阿拉伯按蚊，90.5%；按蚊，9.5%)在该计划范围内1.5 公里内的房屋中显著增多。人类住所靠近灌溉系统增加了疟疾风险，但较高的家庭财富指数降低了风险。因此，对于居住在灌溉地点附近的人们来说，需要采取多部门办法来刺激经济增长，同时减缓疟疾传播的增加。
As countries of sub-Saharan Africa expand irrigation to improve food security and foster economic growth, it is important to quantify the malaria risk associated with this process. Irrigated ecosystems can be associated with increased malaria risk, but this relationship is not fully understood. We studied this relationship at the Bwanje Valley Irrigation Scheme (800 hectares) in Malawi. Household prevalence of malaria and indoor Anopheles density were quantified in two cross-sectional studies in 2016 and 2017 (5,829 residents of 1,091 households). Multilevel logistic regression was used to estimate the association between distance to the irrigation scheme and malaria infection and mosquito density. The prevalence of malaria infection was 50.2% (2,765/5,511) by histidine-rich protein 2–based malaria rapid diagnostic tests and 30.1% (1,626/5,403) by microscopy. Individuals residing in households within 3 km of the scheme had significantly higher prevalence of infection (adjusted odds ratio [aOR] = 1.41; 95% confidence interval [CI] 1.18, 1.68); school-aged children had the highest prevalence among age groups (aOR = 1.34; 95% CI 1.11, 1.63). Individuals who reported bed net use, and households with higher socioeconomic status and higher level of education for household head or spouse, had lower odds of malaria infection. Female Anopheles mosquitoes (2,215 total; Anopheles arabiensis, 90.5%, Anopheles funestus, 9.5%) were significantly more abundant in houses located within 1.5 km of the scheme. Proximity of human dwellings to the irrigation scheme increased malaria risk, but higher household wealth index reduced risk. Therefore, multisectoral approaches that spur economic growth while mitigating increased malaria transmission are needed for people living close to irrigated sites.
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