A steep decline of malaria morbidity and mortality trends in Eritrea between 2000 and 2004: the effect of combination of control methods
A steep decline of malaria morbidity and mortality trends in Eritrea between 2000 and 2004: the effect of combination of control methods
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DOI：
10.1186/1475-2875-5-33
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发表时间：
2006-04-24
期刊：
影响因子：
3
通讯作者：
Okbaldet, Yahannes
中科院分区：
文献类型：
--
作者：
Nyarango, Peter M.;Gebremeskel, Tewolde;Okbaldet, Yahannes
背景：疟疾是非洲一个巨大的公共卫生问题，每年造成100多万人死亡。根据减少疟疾倡议和《阿布贾宣言》，厄立特里亚和其他非洲国家加强了防治疟疾的斗争。本研究审查了厄立特里亚2000 - 2004年减少疟疾方案的影响，以及正在使用的公共卫生干预措施之间的影响和可能的相互作用。方法：本研究采用横断面调查的方法，从家庭、社区和卫生机构收集有关驱虫蚊帐（ITNs）的覆盖率和使用情况、室内滞留喷洒（IRS）、驱虫活动和疟疾病例管理的数据。比较数据来自2001年进行的一项类似调查。来自卫生管理信息系统（HMIS）的数据和国家疟疾控制规划的年度评估报告被用于评估影响。采用时间序列模型（ARIMA）评估相关性。结果：2000 - 2004年期间，分发了大约874 000个蚊帐，对13 109名保健工作者和社区保健人员进行了疟疾病例管理培训。2004年，大约81%的家庭至少拥有一顶蚊帐，其中73%是蚊帐，58.6%的0 - 5岁儿童睡在蚊帐下。由社区卫生机构管理的疟疾病例比例从1999年的50%上升到2004年的78%。滴滴涕和马拉硫磷的总使用量从2000年的6,444公斤增加到2004年的43,491公斤，使受保护的人口从117,017人增加到259,420人。耐药使治疗方案改为氯喹加磺胺多辛-乙胺嘧啶。在此期间，疟疾发病率和病死率分别急剧下降84%和40%。疟疾发病率与ITNs分布数量（beta = - 0.125, p < 0.005）和DDT、马拉硫磷IRS用量（kg） （beta = - 2.352, p < 0.05）密切相关。疟疾病死率与ITNs、IRS、防护人群和年降雨量的相关性无统计学意义。结论：厄立特里亚在5年内实现了关键的减疟目标。ITNs和IRS对降低疟疾发病率贡献最大。
Background: Malaria is a huge public health problem in Africa that is responsible for more than one million deaths annually. In line with the Roll Back Malaria initiative and the Abuja Declaration, Eritrea and other African countries have intensified their fight against malaria. This study examines the impact of Eritrea's Roll Back Malaria Programme: 2000 - 2004 and the effects and possible interactions between the public health interventions in use.Methods: This study employed cross-sectional survey to collect data from households, community and health facilities on coverage and usage of Insecticide-Treated Nets (ITNs), Indoor Residual Spraying (IRS), larvicidal activities and malaria case management. Comparative data was obtained from a similar survey carried out in 2001. Data from the Health Management Information System (HMIS) and reports of the annual assessments by the National Malaria Control Programme was used to assess impact. Time series model (ARIMA) was used to assess association.Results: In the period 2000 - 2004, approximately 874,000 ITNs were distributed and 13,109 health workers and community health agents were trained on malaria case management. In 2004, approximately 81% households owned at least one net, of which 73% were ITNs and 58.6% of children 0 - 5 years slept under a net. The proportion of malaria cases managed by community health agents rose from 50% in 1999 to 78% in 2004. IRS coverage increased with the combined amount of DDT and Malathion used rising from 6,444 kg, in 2000 to 43,491 kg, in 2004, increasing the population protected from 117,017 to 259,420. Drug resistance necessitated regimen change to chloroquine plus sulfadoxine-pyrimethamine. During the period, there was a steep decline in malaria morbidity and case fatality by 84% and 40% respectively. Malaria morbidity was strongly correlated to the numbers of ITNs distributed (beta = - 0.125, p < 0.005) and the amount ( kg) of DDT and Malathion used for IRS (beta = - 2.352, p < 0.05). The correlation between malaria case fatality and ITNs, IRS, population protected and annual rainfall was not statistically significant.Conclusion: Eritrea has within 5 years attained key Roll Back Malaria targets. ITNs and IRS contributed most to reducing malaria morbidity.