Malaria incidence and prevalence on Pemba island before the onset of the successful control intervention on the Zanzibar archipelago.
Malaria incidence and prevalence on Pemba island before the onset of the successful control intervention on the Zanzibar archipelago.
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DOI：
10.1186/1475-2875-9-32
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发表时间：
2010-01-25
期刊：
影响因子：
3
通讯作者：
Sazawal S
中科院分区：
文献类型：
--
作者：
Jaenisch T;Sullivan DJ;Dutta A;Deb S;Ramsan M;Othman MK;Gaczkowski R;Tielsch J;Sazawal S
据报告，在撒哈拉以南非洲部分地区，包括东非的桑给巴尔群岛，疟疾发病率大幅下降。就在疟疾控制干预措施取得巨大成功之前，在奔巴岛进行了一项队列研究和密集的后续行动。所报告的寄生虫流行率和发病率估计数可作为一个可靠的基线，用以评价成功干预措施的效应大小以及质量控制和其他与研究有关的因素在降低传播估计数方面的潜在作用。在一个农村诊所，两个连续的队列537名儿童年龄2-23个月，每个为期6个月，每两周随访一次密集的访问时间表。根据四种不同的疟疾定义，获得了发病率和流行率的可靠估计数。2003-2005年期间，疟疾的发病率和流行率使奔巴岛处于高度流行状态，而不是完全流行状态。总体寄生虫患病率估计为39% -每月估计值在30%至50%之间变化。根据发热诊断和各种基于显微镜的寄生虫阈值，疟疾发病率在每年2.3至3.8次疟疾发作之间，根据发热诊断和类似于快速诊断测试检测的100个寄生虫/微升，疟疾发病率在4.8至5.7次之间。寄生虫密度和疟疾发病率均随年龄和雨季的增加而增加。疟疾发病率也有很大的差异，在研究地区内的各个村庄。奔巴岛以前被认为是疟疾的全地方病。数据表明，2003-2005年奔巴岛的传播情况明显较低，表明存在高度地方性或中度地方性传播环境。这些数字是在桑给巴尔群岛使用浸药蚊帐和室内滞留喷雾杀虫剂进行非常成功的疟疾控制干预之前获得的，提供了控制方案之前疟疾传播情况的可靠估计。这些结果与其他公布的数据一起表明，在控制方案开始之前，疟疾传播已开始减少。疟疾发病率的地方差异突出表明在控制和消灭疟疾方面采取微观流行病学方法的重要性。
Malaria incidence has been reported to decrease substantially in parts of sub-Saharan Africa, including the Zanzibar Archipelago in East Africa. A cohort study with an intensive follow-up on Pemba Island just before the onset of the highly successful malaria control intervention was conducted. The reported estimates of parasite prevalence and incidence can serve as a robust baseline to evaluate the effect size of the successful interventions and the potential contribution of quality controls and other factors associated with research studies in the decreased estimate of transmission. In a rural clinic, two successive cohorts of 537 children total aged 2-23 months were followed for six months each with an intensive visitation schedule of bi-weekly follow-up. Robust estimates of incidence and prevalence according to four different malaria definitions were obtained. Malaria incidence and prevalence placed Pemba Island in a hyperendemic rather than holoendemic setting for the years 2003-2005. Overall parasite prevalence was estimated to be 39% - with monthly estimates varying between 30% and 50%. Incidence of malaria varied between 2.3 and 3.8 malaria episodes per year based on a diagnosis of fever and various microscopy-based parasite thresholds and between 4.8 and 5.7 based on a diagnosis of fever and 100 parasites/microliter analogous to detection by rapid diagnostic tests. Both parasite densities and malaria incidence increased with age and rainy season. Malaria incidence also varied substantially between the individual villages within the study area. Pemba Island was previously considered holo-endemic for Malaria. The data suggest that the transmission situation on Pemba Island was significantly lower in 2003-2005 suggesting a hyper-endemic or meso-endemic transmission environment. The figures were obtained just before the onset of the highly successful malaria control intervention by impregnated bed nets and IRS on the Zanzibar Archipelago and provide robust estimates of the malaria transmission situation prior to the control programme. Together with other published data, the results suggest that malaria transmission had started to decrease before the onset of the control programme. The local heterogeneity in malaria incidence highlights the importance of a micro-epidemiological approach in the context of malaria control and elimination.
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影响因子：
168.9
作者：
Sazawal, Sunil;Black, Robert E.;Kabole, Fatma M.
通讯作者：
Kabole, Fatma M.
影响因子：
2
作者：
SMITH, T;SCHELLENBERG, JA;HAYES, R
通讯作者：
HAYES, R
影响因子：
7.1
作者：
Stoltzfus, RJ;Chwaya, HM;Savioli, L
通讯作者：
Savioli, L
影响因子：
168.9
作者：
Sazawal, S;Black, RE;Kabole, FM
通讯作者：
Kabole, FM
影响因子：
168.9
作者：
Schellenberg, D;Menendez, C;Alonso, P
通讯作者：
Alonso, P