Decreasing incidence of severe malaria and community-acquired bacteraemia among hospitalized children in Muheza, north-eastern Tanzania, 2006-2010.
Decreasing incidence of severe malaria and community-acquired bacteraemia among hospitalized children in Muheza, north-eastern Tanzania, 2006-2010.
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DOI：
10.1186/1475-2875-10-320
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发表时间：
2011-10-27
期刊：
影响因子：
3
通讯作者：
Deen J
中科院分区：
文献类型：
--
作者：
Mtove G;Amos B;Nadjm B;Hendriksen IC;Dondorp AM;Mwambuli A;Kim DR;Ochiai RL;Clemens JD;von Seidlein L;Reyburn H;Deen J
评估了坦桑尼亚Muheza四年期间严重疟疾和社区获得性菌血症的年度发病率和时间趋势。对2006年至2010年在Muheza区医院进行的三项前瞻性研究中2个月至14岁的重症发热儿童的数据进行了汇总和分析。入院时，每个登记的孩子都有一张厚薄的血膜，至少有一次恶性疟疾的快速诊断测试，以及血液培养。计算了来自木合扎的儿童的菌血症和严重疟疾的年发病率，并评估了它们的时间趋势。总体而言，1,898例严重恶性疟疾和684例菌血症病例包括在内。其中，分别有1356人(71%)和482人(71%)来自Muheza的转诊人口。从监测的第一年到第四年，Muheza的恶性疟疾和全因菌血症的发病率分别下降了五倍和三倍(p<；0.0001)。在此期间，穆赫扎地区患有严重疟疾的儿童的年龄中位数从1.7%增加到2.5%(p<；0.0001)。全因菌血症的减少主要是由于非伤寒沙门氏菌病发病率下降了11倍。流感嗜血杆菌和肺炎球菌侵袭性细菌感染的年发病率也有所下降，但数量要少得多。这些结果进一步证明疟疾的减少与非伤寒沙门氏菌病和可能的其他菌血症的减少有关。疟疾预防和控制战略可能比仅仅减少疟疾带来更大的好处。
The annual incidence and temporal trend of severe malaria and community-acquired bacteraemia during a four-year period in Muheza, Tanzania was assessed. Data on severely ill febrile children aged 2 months to 14 years from three prospective studies conducted at Muheza District Hospital from 2006 to 2010 was pooled and analysed. On admission, each enrolled child had a thin and thick blood film and at least one rapid diagnostic test for falciparum malaria, as well as a blood culture. The annual incidence of bacteraemia and severe malaria among children coming from Muheza was calculated and their temporal trend was assessed. Overall, 1, 898 severe falciparum malaria and 684 bacteraemia cases were included. Of these, 1, 356 (71%) and 482 (71%), respectively, were from the referral population of Muheza. The incidence of falciparum malaria and all-cause bacteraemia in Muheza decreased five-fold and three-fold, respectively, from the first to the fourth year of surveillance (p < 0.0001). During this period, the median ages of children from Muheza admitted with severe malaria increased from 1.7 to 2.5 years (p < 0.0001). The reduction in all-cause bacteraemia was mainly driven by the 11-fold decline in the incidence of non-typhoidal salmonellosis. The annual incidences of Haemophilus influenzae and pneumococcal invasive bacterial infections decreased as well but were much fewer in number. These results add to the growing evidence of the decline in malaria associated with a decrease in non-typhoidal salmonellosis and possibly other bacteraemias. Malarial prevention and control strategies may provide a greater benefit than the mere reduction of malaria alone.