Increase in malaria prevalence and age of at risk population in different areas of Gabon.
Increase in malaria prevalence and age of at risk population in different areas of Gabon.
复制标题
DOI：
10.1186/1475-2875-12-3
复制
发表时间：
2013-01-02
期刊：
影响因子：
3
通讯作者：
MCORU team
中科院分区：
文献类型：
--
作者：
Mawili-Mboumba DP;Bouyou Akotet MK;Kendjo E;Nzamba J;Medang MO;Mbina JR;Kombila M;MCORU team
在世界卫生组织提出新的疟疾控制建议后，需要对该疾病的真实的负担作出估计，以更好地查明高危人群并调整控制战略。本研究的目的是估计在加蓬不同地区部署疟疾控制战略6年前后，11岁以下发热儿童疟疾的临床负担。2005年至2011年期间，在四个地点的卫生保健设施进行了横断面调查：两个城市地区（利伯维尔和让蒂尔港），一个半城市地区（梅伦）和一个农村地区（奥耶姆）。使用显微镜对11岁以下的发热儿科患者进行疟疾筛查。收集体温、发热史、年龄、性别和位置。共有16，831名发热儿童入组; 78.5%（n= 13，212）小于5岁。恶性疟原虫感染率在让蒂尔港最低（低于10%），在奥耶姆最高（高于35%）。2005年至2008年期间，疟疾流行率从31.2%大幅下降至18.3%，随后在2011年利伯维尔（24.1%）、让蒂尔港（6.5%）和奥耶姆（44.2%）出现上升（p<0.01）。在整个研究期间，感染患者的中位年龄增加，2011年在利伯维尔达到84（60-108）个月（p<0.01）。从2008年起，在所有地点，5岁以上儿童的感染率更高;感染风险随时间显著增加，2005年从0.37增加到1.50，2011年从2.03增加到5.10（p<0.01）。2008年至2011年，5岁以下儿童感染恶性疟原虫的风险显著降低（p<0.01）。这项研究表明，加蓬不同地区感染疟疾的风险增加，5岁以上的儿童往往成为最危险的人群，这表明流行病学正在发生变化。此外，该国疟疾负担的多样性突出表明，必须维持各种疟疾防治战略，并重新确定其执行工作。
Following the deployment of new recommendations for malaria control according to the World Health Organization, an estimation of the real burden of the disease is needed to better identify populations at risk and to adapt control strategies. The aim of the present study was to estimate the clinical burden of malaria among febrile children aged less than 11 years, before and after six-year of deployment of malaria control strategies in different areas of Gabon. Cross-sectional surveys were carried out in health care facilities at four locations: two urban areas (Libreville and Port-Gentil), one semi-urban area (Melen) and one rural area (Oyem), between 2005 and 2011. Febrile paediatric patients, aged less than 11 years old were screened for malaria using microscopy. Body temperature, history of fever, age, sex, and location were collected. A total of 16,831 febrile children were enrolled; 78.5% (n=13,212) were less than five years old. The rate of Plasmodium falciparum-infection was the lowest in Port-gentil (below 10%) and the highest at Oyem (above 35%). Between 2005 and 2008, malaria prevalence dropped significantly from 31.2% to 18.3%, followed by an increase in 2011 in Libreville (24.1%), Port-Gentil (6.5%) and Oyem (44.2%) (p<0.01). Median age among the infected patients increased throughout the study period reaching 84 (60–108) months in Libreville in 2011 (p<0.01). From 2008, at all sites, children older than five years were more frequently infected; the risk of being infected significantly increased with time, ranging from 0.37 to 1.50 in 2005 and from 2.03 to 5.10 in 2011 in this group (p<0.01). The risk of being P. falciparum-infected in children aged less than five years old significantly decreased from 2008 to 2011 (p<0.01). This study shows an increased risk of malaria infection in different areas of Gabon with over-five year-old children tending to become the most at-risk population, suggesting a changing epidemiology. Moreover, the heterogeneity of the malaria burden in the country highlights the importance of maintaining various malaria control strategies and redefining their implementation.
登录
查看更多内容
影响因子：
56.3
作者：
Hay, Simon I.;Smith, David L.;Snow, Robert W.
通讯作者：
Snow, Robert W.
影响因子：
3
作者：
Manjurano A;Okell L;Lukindo T;Reyburn H;Olomi R;Roper C;Clark TG;Joseph S;Riley EM;Drakeley C
通讯作者：
Drakeley C
影响因子：
168.9
作者：
Noor, Abdisalan M.;Mutheu, Juliette J.;Tatem, Andrew J.;Hay, Simon I.;Snow, Robert W.
通讯作者：
Snow, Robert W.
影响因子：
3.7
作者：
Haque, Ubydul;Ahmed, Syed Masud;Haque, Rashidul
通讯作者：
Haque, Rashidul
影响因子：
3
作者：
De Beaudrap, Pierre;Nabasumba, Carolyn;Etard, Jean-Francois
通讯作者：
Etard, Jean-Francois