Stratification at the health district level for targeting malaria control interventions in Mali.
Stratification at the health district level for targeting malaria control interventions in Mali.
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DOI：
10.1038/s41598-022-11974-3
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发表时间：
2022-05-18
影响因子：
4.6
通讯作者：
中科院分区：
文献类型：
--
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疟疾是马里发病和死亡的主要原因。2017年至2020年期间，该国的病例数有所增加，2020年确诊病例为288.4827万例，死亡病例为1454例。我们在马里的卫生区一级进行了疟疾风险分层，以期提出有针对性的控制干预措施。疟疾确诊病例数据来自地区卫生信息软件2,6-59个月儿童疟疾患病率和死亡率数据来自2018年人口与健康调查，昆虫学数据来自马里国家疟疾控制规划（NMCP）哨点疟疾研究机构，环境数据来自美国国家航空航天局。对疟疾风险进行了分层。根据疟疾发病率、儿童疟疾流行率、病媒耐药性分布、卫生设施使用情况、儿童死亡率和传播季节性的空间异质性，选择了有针对性的疟疾控制干预措施。与NMCP和不同的供资伙伴讨论了这些干预措施。2017-2019年，75个卫生区的中位发病率为每1000人年129.34例（标准差= 86.48）。风险分层确定了极低传播区有12个卫生区，低传播区有19个，中度传播区有20个，高传播区有24个。在高传播地区，卫生设施使用率低，病媒耐药性增加。选择8种干预组合实施。我们的工作利用先进的统计方法提供了最新的风险分层，为马里疟疾控制干预措施的目标提供信息。这种分层可以作为在马里和其他国家持续进行疟疾风险分层的模板。
Malaria is the leading cause of morbidity and mortality in Mali. Between 2017 and 2020, the number of cases increased in the country, with 2,884,827 confirmed cases and 1454 reported deaths in 2020. We performed a malaria risk stratification at the health district level in Mali with a view to proposing targeted control interventions. Data on confirmed malaria cases were obtained from the District Health Information Software 2, data on malaria prevalence and mortality in children aged 6–59 months from the 2018 Demographic and Health Survey, entomological data from Malian research institutions working on malaria in the sentinel sites of the National Malaria Control Program (NMCP), and environmental data from the National Aeronautics and Space Administration. A stratification of malaria risk was performed. Targeted malaria control interventions were selected based on spatial heterogeneity of malaria incidence, malaria prevalence in children, vector resistance distribution, health facility usage, child mortality, and seasonality of transmission. These interventions were discussed with the NMCP and the different funding partners. In 2017–2019, median incidence across the 75 health districts was 129.34 cases per 1000 person-years (standard deviation = 86.48). Risk stratification identified 12 health districts in very low transmission areas, 19 in low transmission areas, 20 in moderate transmission areas, and 24 in high transmission areas. Low health facility usage and increased vector resistance were observed in high transmission areas. Eight intervention combinations were selected for implementation. Our work provides an updated risk stratification using advanced statistical methods to inform the targeting of malaria control interventions in Mali. This stratification can serve as a template for continuous malaria risk stratifications in Mali and other countries.
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影响因子：
3.3
作者：
Coulibaly, Drissa;Travassos, Mark A.;Gaudart, Jean
通讯作者：
Gaudart, Jean
影响因子：
3
作者：
Coulibaly, Boubacar;Kone, Raymond;Riehle, Michelle M.
通讯作者：
Riehle, Michelle M.
影响因子：
12
作者：
Erdman, Laura K;Kain, Kevin C
通讯作者：
Kain, Kevin C
DOI：
10.3390/ijerph17113982
发表时间：
2020-06-01
影响因子：
--
作者：
Cissoko, Mady;Sagara, Issaka;Gaudart, Jean
通讯作者：
Gaudart, Jean
影响因子：
4.5
作者：
Ghimire, Prakash;Rijal, Komal Raj;Hii, Jeffrey
通讯作者：
Hii, Jeffrey