The 2015-2016 malaria epidemic in Northern Uganda; What are the implications for malaria control interventions?
The 2015-2016 malaria epidemic in Northern Uganda; What are the implications for malaria control interventions?
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DOI：
10.1016/j.actatropica.2018.08.023
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发表时间：
2018-12
期刊：
影响因子：
2.7
通讯作者：
Idro R
中科院分区：
文献类型：
--
作者：
Ogwang R;Akena G;Yeka A;Osier F;Idro R
病媒控制和有效的病例管理是目前疟疾控制的主要战略。基特古姆区是乌干达北部一个常年全地方性疟疾传播强度高的地区，2015年似乎出现了疟疾流行。本研究旨在描述2011 - 2017年Kitgum总医院疟疾趋势与气候因素和基于人群的疟疾控制干预措施的应用的关系。回顾性检查了医院记录，以计算疟疾正常渠道、每1000人疟疾病例、检测阳性率（TPR），并列举妊娠疟疾、住院和死亡。介绍了在此期间采用的气候因素（湿度、温度和降雨）和基于人群的疟疾控制干预措施。基特古姆区在2015年至2016年期间经历了一场流行病；疟疾的负担超过了既定的正常渠道。在高峰期，到KGH就诊的疟疾病例数是正常渠道的20多倍。每千人总病例数从2014年的7例增加到2015年的113例和2016年的114例（趋势p值< 0.0001）。同样，TPR在2014年至2016年间从10.5%上升到54.6% （p值< 0.0001）。这一趋势也出现在因疟疾而住院的病例和孕期疟疾病例中。各气候因子均无显著变化（相对湿度、最高温度和降雨量的p值分别为0.92、0.99和0.52）。疟疾激增的同时，疟疾控制干预措施的使用和应用也普遍减少。具体而言，2014年室内滞留喷洒中断。为应对这一流行病，2017年重新使用了IRS，同时大规模分发了长效杀虫剂处理过的蚊帐。随后，所有疟疾指标都有所下降。基特古姆的疫情与IRS中断有关，在与LLINs一起重新引入IRS后似乎有所减弱。这项研究表明，为了在疟疾传播强度高的地区消除疟疾，可能需要长期维持有效的控制措施。
Vector control and effective case management are currently the backbone strategies of malaria control. Kitgum district, an area of perennial holoendemic malaria transmission intensity in Northern Uganda, appears to have experienced a malaria epidemic in 2015. This study aimed to describe the malaria trends in Kitgum General Hospital from 2011 to 2017 in relation to climatic factors and the application of population-based malaria control interventions. Hospital records were examined retrospectively to calculate malaria normal channels, malaria cases per 1000 population, test positivity rates (TPR) and to enumerate pregnancy malaria, hospitalizations and deaths. Climatic factors (humidity, temperature and rainfall) and population-based malaria control interventions that had been applied during this period were described. Kitgum district experienced an epidemic between the years 2015 and 2016; the malaria burden rose above the established normal channels. At its peak the number of malaria cases attending KGH was over 20 times above the normal channels. The total number of cases per 1000 population increased from 7 in 2014 to 113 in 2015 and 114 in 2016 (p value for trend < 0.0001). Similarly, TPR increased from 10.5% to 54.6% between 2014 and 2016 (p value for trend < 0.0001). This trend was also observed for malaria attributable hospitalizations, and malaria in pregnancy. There were no significant changes in any of the climatic factors assessed (p value=0.92, 0.99, 0.52 for relative humidity, max temperature, and rainfall, respectively). The malaria upsurge occurred in conjunction with a general decline in the use and application of malaria control interventions. Specifically, indoor residual spraying was interrupted in 2014. In response to the epidemic, IRS was reapplied together with mass distribution of long-lasting insecticide treated nets (LLINs) in 2017. Subsequently, there was a decline in all malaria indicators. The epidemic in Kitgum occurred in association with the interruption of IRS and appears to have abated following its re-introduction alongside LLINs. The study suggests that to enable malaria elimination in areas of high malaria transmission intensity, effective control measures may need to be sustained for the long-term.
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影响因子：
15.8
作者：
Katureebe A;Zinszer K;Arinaitwe E;Rek J;Kakande E;Charland K;Kigozi R;Kilama M;Nankabirwa J;Yeka A;Mawejje H;Mpimbaza A;Katamba H;Donnelly MJ;Rosenthal PJ;Drakeley C;Lindsay SW;Staedke SG;Smith DL;Greenhouse B;Kamya MR;Dorsey G
通讯作者：
Dorsey G
影响因子：
3
作者：
Boyce RM;Muiru A;Reyes R;Ntaro M;Mulogo E;Matte M;Siedner MJ
通讯作者：
Siedner MJ
DOI：
10.4269/ajtmh.15-0007
发表时间：
2015-09
期刊：
The American journal of tropical medicine and hygiene
影响因子：
--
作者：
Cui L;Mharakurwa S;Ndiaye D;Rathod PK;Rosenthal PJ
通讯作者：
Rosenthal PJ
DOI：
10.1016/s0035-9203(99)90344-9
发表时间：
1999-09-01
影响因子：
2.2
作者：
Lindblade, KA;Walker, ED;Wilson, ML
通讯作者：
Wilson, ML
影响因子：
3
作者：
Kitutu, Freddy Eric;Kalyango, Joan Nakayaga;Wamani, Henry
通讯作者：
Wamani, Henry