A malaria risk map of Kinshasa, Democratic Republic of Congo.
A malaria risk map of Kinshasa, Democratic Republic of Congo.
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DOI：
10.1186/s12936-015-1074-8
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发表时间：
2016-01-13
期刊：
影响因子：
3
通讯作者：
Lengeler C
中科院分区：
文献类型：
--
作者：
Ferrari G;Ntuku HM;Schmidlin S;Diboulo E;Tshefu AK;Lengeler C
在金沙萨，疟疾仍然是一个主要的公共卫生问题，但其空间流行病学几十年来一直没有得到评估。城市的发展和转型，以及最近的控制措施，需要更新。为了确定不太需要采取控制措施的高度暴露社区和地区，需要详细的风险地图，以确定控制目标并优化资源分配。2009年（旱季结束）和2011年（雨季结束），在金沙萨进行了两次横断面调查，以确定6-59个月儿童的疟疾流行、贫血、发热史、蚊帐拥有率和使用情况。利用地理信息系统（GIS）在卫生区（HA）一级绘制了关键参数的地理参考数据。在来自33个卫生区（HZs）的7517名6-59个月的儿童中，6661名（2009年为3319名，2011年为3342名）接受了疟疾（通过快速诊断测试）和贫血的检测，856名（2009年为845名，2011年为11名）仅接受了贫血检测。2009年和2011年分别抽取了15个和25个区域，两次调查都抽取了7个区域。疟疾和贫血的平均患病率2009年为6.4%（5.6-7.4）和65.1%(63.7-66.6)，2011年为17.0%（15.7-18.3）和64.2%（62.6-65.9）。在两项调查抽样的两个疫区中，2009年旱季和2011年雨季，Selembao（近郊）的疟疾流行率分别为14.1%和26.8%,Ngiri Ngiri（市区）的疟疾流行率分别为1.0%和0.8%。2009年和2011年前两周发热史分别为13.2%（12.5 - 14.3%）和22.3%（20.8-23.4）。两个时间点家庭至少拥有一顶驱虫蚊帐（ITN）的比例分别为78.7%（77.4-80.0）和65.0%(63.7-66.3)，使用率分别为57.7%（56.0-59.9）和45.0%（43.6-46.8）。这项研究展示了金沙萨的第一张疟疾风险地图，金沙萨是一个拥有大约1000万居民的特大城市，位于疟疾高发地区。在城市地区，疟疾、贫血和报告发烧的流行率较低，而在城郊地区，蚊帐覆盖率低和净使用率不理想的情况很常见。
In Kinshasa, malaria remains a major public health problem but its spatial epidemiology has not been assessed for decades now. The city’s growth and transformation, as well as recent control measures, call for an update. To identify highly exposed communities and areas where control measures are less critically needed, detailed risk maps are required to target control and optimize resource allocation. In 2009 (end of the dry season) and 2011 (end of the rainy season), two cross-sectional surveys were conducted in Kinshasa to determine malaria prevalence, anaemia, history of fever, bed net ownership and use among children 6–59 months. Geo-referenced data for key parameters were mapped at the level of the health area (HA) by means of a geographic information system (GIS). Among 7517 children aged 6–59 months from 33 health zones (HZs), 6661 (3319 in 2009 and 3342 in 2011) were tested for both malaria (by Rapid Diagnostic Tests) and anaemia, and 856 (845 in 2009 and 11 in 2011) were tested for anaemia only. Fifteen HZs were sampled in 2009, 25 in 2011, with seven HZs sampled in both surveys. Mean prevalence for malaria and anaemia was 6.4 % (5.6–7.4) and 65.1 % (63.7–66.6) in 2009, and 17.0 % (15.7–18.3) and 64.2 % (62.6–65.9) in 2011. In two HZs sampled in both surveys, malaria prevalence was 14.1 % and 26.8 % in Selembao (peri-urban), in the 2009 dry season and 2011 rainy season respectively, and it was 1.0 % and 0.8 % in Ngiri Ngiri (urban). History of fever during the preceding two weeks was 13.2 % (12.5–14.3) and 22.3 % (20.8–23.4) in 2009 and 2011. Household ownership of at least one insecticide-treated net (ITN) was 78.7 % (77.4–80.0) and 65.0 % (63.7–66.3) at both time points, while use was 57.7 % (56.0–59.9) and 45.0 % (43.6–46.8), respectively. This study presents the first malaria risk map of Kinshasa, a mega city of roughly 10 million inhabitants and located in a highly endemic malaria zone. Prevalence of malaria, anaemia and reported fever was lower in urban areas, whereas low coverage of ITN and sub-optimal net use were frequent in peri-urban areas.