Assessing the Risk Factors Associated with Malaria in the Highlands of Ethiopia: What Do We Need to Know?
Assessing the Risk Factors Associated with Malaria in the Highlands of Ethiopia: What Do We Need to Know?
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DOI：
10.3390/tropicalmed2010004
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发表时间：
2017-03-01
影响因子：
2.9
通讯作者：
Webb, Cameron Ewart
中科院分区：
文献类型：
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作者：
Vajda, Elodie Anne;Webb, Cameron Ewart
几十年来，疟疾一直是埃塞俄比亚的主要传染病。在2003-2004年灾难性的疟疾暴发之后，联邦卫生部(FMoH)采取了激进的公共卫生行动，以减轻疟疾的负担。卫生部实现了疟疾死亡率和发病率的显著下降，最近宣布其目标是到2020年在埃塞俄比亚疟疾低传播区消除疟疾。然而，虽然总体疟疾流行率有所下降，但在以前被认为是“无疟疾”的地区，越来越多地出现不可预测的暴发。这种暴发对这些地区的人口造成灾难性后果，因为他们对疟疾没有免疫力。阿姆哈拉地区占埃塞俄比亚疟疾负担的31%，是卫生部消灭疟疾的目标。阿姆哈拉的流行病监测系统面临着许多挑战，要及时发现在其他低传播率地区发生的不可预测和不规律的疟疾暴发。尽管有证据表明疟疾传播模式发生了转变，但阿姆哈拉的疟疾控制干预措施仍然局限于历史上已知疟疾传播稳定的地区。本文讨论了温度和降水变异性、昆虫学参数和人口流动对阿姆哈拉地区疟疾传播模式的影响，特别是在传播不稳定的地区。我们认为，除了环境和昆虫学因素外，通过考虑人口流动，疟疾流行病学监测系统可以得到改善。然而，到目前为止，还没有研究统计分析人口动态对疟疾传播的环境和昆虫学驱动因素的相互影响。
Malaria has been Ethiopia's predominant communicable disease for decades. Following the catastrophic malaria outbreak in 2003-2004, the Federal Ministry of Health (FMoH) took drastic public health actions to lower the burden of malaria. The FMoH achieved significant declines in malaria mortality and incidence, and recently declared its objective to achieve malaria elimination in low malaria transmission areas of Ethiopia by 2020. However, while the overall malaria prevalence has decreased, unpredictable outbreaks increasingly occur irregularly in regions previously considered "malaria-free". Such outbreaks have disastrous consequences on populations of these regions as they have no immunity against malaria. The Amhara Region accounts for 31% of Ethiopia's malaria burden and is targeted for malaria elimination by the FMoH. Amhara's epidemiological surveillance system faces many challenges to detect in a timely manner the unpredictable and irregular malaria outbreaks that occur in areas of otherwise low transmission. Despite the evidence of a shift in malaria transmission patterns, Amhara's malaria control interventions remain constrained to areas that are historically known to have stable malaria transmission. This paper discusses the influence of temperature and precipitation variability, entomological parameters, and human population mobility on malaria transmission patterns across the Amhara Region, and in particular, in areas of unstable transmission. We argue that malaria epidemiological surveillance systems can be improved by accounting for population movements in addition to environmental and entomological factors. However, to date, no study has statistically analyzed the interplay of population dynamics on environmental and entomological drivers of malaria transmission.