Micro-epidemiology of malaria in an elimination setting in Central Vietnam.
Micro-epidemiology of malaria in an elimination setting in Central Vietnam.
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DOI：
10.1186/s12936-018-2262-0
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发表时间：
2018-03-19
期刊：
影响因子：
3
通讯作者：
Erhart A
中科院分区：
文献类型：
--
作者：
Bannister-Tyrrell M;Xa NX;Kattenberg JH;Van Van N;Dung VKA;Hieu TM;Van Hong N;Rovira-Vallbona E;Thao NT;Duong TT;Rosanas-Urgell A;Peeters Grietens K;Erhart A
在越南，疟疾在偏远森林地区持续存在，这些地区的感染具有空间异质性，大多数无症状且寄生虫密度低。越南之前的研究调查了广泛的行为概念，例如“从事森林活动”作为疟疾感染的风险因素，这可能无法解释疟疾风险的异质性，特别是在消除疟疾的环境中。在越南中部广南省南茶美县的三个少数民族村庄进行的为期一年的疟疾计量队列研究中，纳入了一项将人种学研究和横断面调查相结合的混合方法研究。定性数据收集包括两个月内的深入访谈、非正式对话和参与者观察，调查结果用于制定横断面调查中使用的调查问卷。后者收集有关夜间活动、流动模式和家庭特征的数据。主要结果是最近接触疟疾，使用分类和回归树方法确定调查前一年抗体滴度的显着变化。使用逻辑回归对近期接触疟疾的危险因素进行分析。人种学研究期间（2015年4月至6月）记录了22次深度访谈和大量参与者观察，160名成年人（86%的回应率）对横断面调查（2015年11月至12月）做出了回应。据估计，最近接触恶性疟原虫疟疾的人数为 22.9%，接触间日疟原虫的人数为 17.1%。持续的疟疾传播似乎是通过延迟或扰乱在悬挂蚊帐的永久性结构中睡眠的活动来维持的，包括晚间饮酒聚会、钓鱼、森林伐木和户外电视观看。用于村庄以及农场、森林和河流地点户外晚间活动的病媒控制工具应纳入越南中部当前的疟疾消除工作中。使用混合方法设计的微观流行病学研究可以在精细空间尺度上全面了解疟疾风险，并更好地为消除疟疾的针对性干预措施的实施提供信息。本文的在线版本 (10.1186/s12936-018-2262-0) 包含补充材料，可供授权用户使用。
In Vietnam, malaria persists in remote forested regions where infections are spatially heterogeneous, mostly asymptomatic and with low parasite density. Previous studies in Vietnam have investigated broad behavioural concepts such as ‘engaging in forest activities’ as risk factors for malaria infection, which may not explain heterogeneity in malaria risk, especially in malaria elimination settings. A mixed methods study combining ethnographic research and a cross-sectional survey was embedded in a 1-year malariometric cohort study in three ethnic minority villages in South Tra My district, Quang Nam Province in Central Vietnam. Qualitative data collection included in-depth interviews, informal conversations and participant observations over a 2-month period, and the findings were used to develop the questionnaire used in the cross-sectional survey. The latter collected data on evening activities, mobility patterns and household characteristics. The primary outcome, recent exposure to malaria, was defined using the classification and regression tree method to determine significant changes in antibody titres during the year preceding the survey. Risk factor analyses for recent exposure to malaria were conducted using logistic regression. 22 in-depth interviews and numerous participant observations were recorded during the ethnographic research (April to June 2015), and 160 adults (86% response rate) responded to the cross-sectional survey (November to December 2015). Recent exposure to Plasmodium falciparum malaria was estimated at 22.9 and at 17.1% for Plasmodium vivax. Ongoing malaria transmission appears to be maintained by activities that delay or disrupt sleeping in a permanent structure in which a bed net could be hung, including evening drinking gatherings, fishing, logging in the forest and outdoor TV watching. Vector control tools for outdoor evening activities in villages as well as at farms, forest and river locations should be incorporated into current malaria elimination efforts in Central Vietnam. Micro-epidemiology studies using mixed-methods designs can provide a comprehensive understanding of the malaria risk at fine spatial scales and better inform the implementation of targeted interventions for malaria elimination. The online version of this article (10.1186/s12936-018-2262-0) contains supplementary material, which is available to authorized users.
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DOI：
10.1038/nri2394
发表时间：
2008-09
期刊：
Nature reviews. Immunology
影响因子：
--
作者：
Fish EN
通讯作者：
Fish EN
影响因子：
6.4
作者：
Bousema, Teun;Drakeley, Chris;Gosling, Roly
通讯作者：
Gosling, Roly
影响因子：
2.7
作者：
Cui, Liwang;Yan, Guiyun;Sattabongkot, Jetsumon;Cao, Yaming;Chen, Bin;Chen, Xiaoguang;Fan, Qi;Fang, Qiang;Jongwutiwes, Somchai;Parker, Daniel;Sirichaisinthop, Jeeraphat;Kyaw, Myat Phone;Su, Xin-zhuan;Yang, Henglin;Yang, Zhaoqing;Wang, Baomin;Xu, Jianwei;Zheng, Bin;Zhong, Daibin;Zhou, Guofa
通讯作者：
Zhou, Guofa
DOI：
10.1073/pnas.0408725102
发表时间：
2005-04-05
影响因子：
11.1
作者：
Drakeley, CJ;Corran, PH;Riley, EM
通讯作者：
Riley, EM
影响因子：
10
作者：
Foo, Yong Zhi;Nakagawa, Shinichi;Simmons, Leigh W.
通讯作者：
Simmons, Leigh W.