The decline in paediatric malaria admissions on the coast of Kenya.
The decline in paediatric malaria admissions on the coast of Kenya.
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DOI：
10.1186/1475-2875-6-151
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发表时间：
2007-11-15
期刊：
影响因子：
3
通讯作者：
Snow RW
中科院分区：
文献类型：
--
作者：
Okiro EA;Hay SI;Gikandi PW;Sharif SK;Noor AM;Peshu N;Marsh K;Snow RW
关于扩大非洲疟疾控制和预防战略覆盖范围对健康的影响的信息有限。儿科入院数据是在 8.25 年间从三个地区医院收集的；基利菲、姆桑布韦尼和马林迪位于肯尼亚海岸沿线。使用几个时间序列模型分析了 1999 年 1 月至 2007 年 3 月期间每月因疟疾入院的趋势，并根据每月非疟疾入院率以及降雨量的季节性和趋势进行了调整。自 1999 年 1 月以来，所有医院因疟疾住院的儿童人数均大幅下降。这一趋势是在非疟疾入院人数增加或持续增加的背景下观察到的，并且在整个监测期间未受到长期降雨的影响。到 2007 年 3 月，估计基利菲的疟疾病例下降了 63%，夸勒下降了 53%，马林迪下降了 28%。时间序列模型强烈表明，观察到的疟疾入院人数下降是医院服务区域针对疟疾的控制工作的结果。这项研究提供了肯尼亚海岸疾病负担不断变化的证据，最简单的解释是扩大干预措施的覆盖范围，例如使用经过杀虫剂处理的蚊帐和提供抗疟疾药物。虽然无法计算干预覆盖范围的具体归因，但可以明确的是，肯尼亚这一地区正在经历疟疾流行病学转变。
There is only limited information on the health impact of expanded coverage of malaria control and preventative strategies in Africa. Paediatric admission data were assembled over 8.25 years from three District Hospitals; Kilifi, Msambweni and Malindi, situated along the Kenyan Coast. Trends in monthly malaria admissions between January 1999 and March 2007 were analysed using several time-series models that adjusted for monthly non-malaria admission rates and the seasonality and trends in rainfall. Since January 1999 paediatric malaria admissions have significantly declined at all hospitals. This trend was observed against a background of rising or constant non-malaria admissions and unaffected by long-term rainfall throughout the surveillance period. By March 2007 the estimated proportional decline in malaria cases was 63% in Kilifi, 53% in Kwale and 28% in Malindi. Time-series models strongly suggest that the observed decline in malaria admissions was a result of malaria-specific control efforts in the hospital catchment areas. This study provides evidence of a changing disease burden on the Kenyan coast and that the most parsimonious explanation is an expansion in the coverage of interventions such as the use of insecticide-treated nets and the availability of anti-malarial medicines. While specific attribution to intervention coverage cannot be computed what is clear is that this area of Kenya is experiencing a malaria epidemiological transition.
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影响因子：
3.3
作者：
Shretta, R;Omumbo, J;Snow, RW
通讯作者：
Snow, RW
影响因子：
3.3
作者：
Amin, AA;Hughes, DA;Snow, RW
通讯作者：
Snow, RW
影响因子：
2.7
作者：
DURBIN, J;WATSON, GS
通讯作者：
WATSON, GS
影响因子：
3.3
作者：
Noor, AM;Amin, AA;Snow, RW
通讯作者：
Snow, RW
影响因子：
3.2
作者：
Snow, RW;McCabe, E;Nevill, CG
通讯作者：
Nevill, CG