Key traveller groups of relevance to spatial malaria transmission: a survey of movement patterns in four sub-Saharan African countries.
Key traveller groups of relevance to spatial malaria transmission: a survey of movement patterns in four sub-Saharan African countries.
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DOI：
10.1186/s12936-016-1252-3
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发表时间：
2016-04-12
期刊：
影响因子：
3
通讯作者：
Ghani AC
中科院分区：
文献类型：
--
作者：
Marshall JM;Touré M;Ouédraogo AL;Ndhlovu M;Kiware SS;Rezai A;Nkhama E;Griffin JT;Hollingsworth TD;Doumbia S;Govella NJ;Ferguson NM;Ghani AC
随着疟疾流行率在世界许多地区因疟疾控制工作而下降，以及抗药性寄生虫开始出现，对人类活动的定量了解对疟疾控制越来越重要。然而，尽管人口流动很重要，但在这方面仍然存在重大的知识差距，特别是在撒哈拉以南非洲。在撒哈拉以南非洲的马里、布基纳法索、赞比亚和坦桑尼亚四个国家进行了人员流动模式的定量调查，在每个国家选择了三到五个调查地点。调查内容包括人口统计和旅行详情、疟疾风险行为、陪同旅行者的儿童以及移动的电话使用情况，以使电话信号数据更好地与移动情况相关联。共采访了4352人，记录了6411次旅行。对旅行的聚类分析突出了与疟疾传播有关的两个不同的旅行者群体：携带儿童旅行的妇女（在所有四个国家）和青年工人（在马里）。携带儿童旅行的妇女更有可能前往马里疟疾流行率相对较高的地区（OR = 4.46，95% CI = 3.42-5.83），布基纳法索（OR = 1.58，95%CI = 1.23-1.58）、赞比亚（OR = 1.50，95%CI = 1.20-1.89）和坦桑尼亚（OR = 2.28，95%CI = 1.71-3.05）。在布基纳法索，他们也更有可能拥有蚊帐（OR = 1.77，95%CI = 1.25-2.53）和赞比亚（OR = 1.74，95% CI = 1.34 2.27），在马里拥有移动的手机的可能性较小（OR = 0.50，95%CI = 0.39-0.65）、布基纳法索（OR = 0.39，95%CI = 0.30-0.52）和赞比亚（OR = 0.60，95%CI = 0.47-0.76）。与其他旅行者相比，马里青年工人更有可能前往疟疾流行率相对较高的地区（OR = 23，95% CI = 17-31），旅行时间更长（平均70天vs 21天，p < 0.001）。在接受调查的所有四个国家中，带孩子旅行的妇女是一个非常一致的旅行者群体。预计他们将大大促进疟疾的空间传播，因为与他们同行的儿童往往寄生虫感染率很高。青年工作者是马里的一个重要旅行者群体，预计将大大促进疟疾的空间传播，因为他们的流动与季节性降雨相关，因此蚊子密度达到高峰。旨在阻断寄生虫空间传播的干预措施应考虑这些旅行者群体。本文的在线版本（doi：10.1186/s12936-016-1252-3）包含补充材料，可供授权用户使用。
As malaria prevalence declines in many parts of the world due to widescale control efforts and as drug-resistant parasites begin to emerge, a quantitative understanding of human movement is becoming increasingly relevant to malaria control. However, despite its importance, significant knowledge gaps remain regarding human movement, particularly in sub-Saharan Africa. A quantitative survey of human movement patterns was conducted in four countries in sub-Saharan Africa: Mali, Burkina Faso, Zambia, and Tanzania, with three to five survey locations chosen in each country. Questions were included on demographic and trip details, malaria risk behaviour, children accompanying travellers, and mobile phone usage to enable phone signal data to be better correlated with movement. A total of 4352 individuals were interviewed and 6411 trips recorded. A cluster analysis of trips highlighted two distinct traveller groups of relevance to malaria transmission: women travelling with children (in all four countries) and youth workers (in Mali). Women travelling with children were more likely to travel to areas of relatively high malaria prevalence in Mali (OR = 4.46, 95 % CI = 3.42–5.83), Burkina Faso (OR = 1.58, 95 % CI = 1.23–1.58), Zambia (OR = 1.50, 95 % CI = 1.20–1.89), and Tanzania (OR = 2.28, 95 % CI = 1.71–3.05) compared to other travellers. They were also more likely to own bed nets in Burkina Faso (OR = 1.77, 95 % CI = 1.25–2.53) and Zambia (OR = 1.74, 95 % CI = 1.34 2.27), and less likely to own a mobile phone in Mali (OR = 0.50, 95 % CI = 0.39–0.65), Burkina Faso (OR = 0.39, 95 % CI = 0.30–0.52), and Zambia (OR = 0.60, 95 % CI = 0.47–0.76). Malian youth workers were more likely to travel to areas of relatively high malaria prevalence (OR = 23, 95 % CI = 17–31) and for longer durations (mean of 70 days cf 21 days, p < 0.001) compared to other travellers. Women travelling with children were a remarkably consistent traveller group across all four countries surveyed. They are expected to contribute greatly towards spatial malaria transmission because the children they travel with tend to have high parasite prevalence. Youth workers were a significant traveller group in Mali and are expected to contribute greatly to spatial malaria transmission because their movements correlate with seasonal rains and hence peak mosquito densities. Interventions aimed at interrupting spatial transmission of parasites should consider these traveller groups. The online version of this article (doi:10.1186/s12936-016-1252-3) contains supplementary material, which is available to authorized users.