Geographical and temporal variation in reduction of malaria infection among children under 5 years of age throughout Nigeria.
Geographical and temporal variation in reduction of malaria infection among children under 5 years of age throughout Nigeria.
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DOI：
10.1136/bmjgh-2020-004250
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发表时间：
2021-03
影响因子：
8.1
通讯作者：
Conway D
中科院分区：
文献类型：
--
作者：
Oyibo W;Ntadom G;Uhomoibhi P;Oresanya O;Ogbulafor N;Ajumobi O;Okoh F;Maxwell K;Ezeiru S;Nwokolo E;Amajoh C;Ezeigwe N;Audu M;Conway D
自2015年以来，全球减少疟疾的进展停滞不前。特别需要对尼日利亚的情况进行分析，因为该国迄今承担的负担最大，据估计，全世界约有四分之一的病例发生在该国。我们分析了三项全国性调查（2010年和2015年的疟疾指标调查以及2018年的全国人口与健康调查）的数据，通过从尼日利亚所有36个州抽样确定5岁以下儿童的疟疾寄生虫患病率，并在同一认可实验室对所有样本进行血液载玻片显微镜检查。通过计算每个州的患病率（PR）值和95% CI，以及该国六个主要地缘政治区域的Mantel-Haenszel调整的PR（PRadj），评估随时间的变化。在2010年至2018年期间，25个州的寄生虫患病率显着下降，但其余11个州没有。在该国南部地区（西南PRadj=0.53;东南PRadj=0.59;南南PRadj=0.51）和中北部地区（PRadj=0.36），流行率下降最多。北部的变化不太明显，但也很显著，表明总体减少了20%以上（西北PRadj=0.74;东北PRadj=0.70）。南部的变化主要发生在2010年至2015年之间，而北部的变化则更为渐进，大多数持续到2015年之后。最近的变化与调查报告的使用预防措施的变化无关。自2010年以来，尼日利亚大多数州的5岁以下儿童疟疾感染率有所下降，但时间和程度上的巨大地理差异表明，要实现全球疟疾减少，还需要克服挑战。
Global progress in reducing malaria has stalled since 2015. Analysis of the situation is particularly needed in Nigeria, the country with by far the largest share of the burden, where approximately a quarter of all cases in the world are estimated to occur. We analysed data from three nationwide surveys (Malaria Indicator Surveys in 2010 and 2015 and a National Demographic and Health Survey in 2018), with malaria parasite prevalence in children under 5 years of age determined by sampling from all 36 states of Nigeria, and blood slide microscopy performed in the same accredited laboratory for all samples. Changes over time were evaluated by calculating prevalence ratio (PR) values with 95% CIs for each state, together with Mantel-Haenszel-adjusted PRs (PRadj) for each of the six major geopolitical zones of the country. Between 2010 and 2018, there were significant reductions in parasite prevalence in 25 states, but not in the remaining 11 states. Prevalence decreased most in southern zones of the country (South West PRadj=0.53; South East PRadj=0.59; South South PRadj=0.51) and the North Central zone (PRadj=0.36). Changes in the north were less marked, but were significant and indicated overall reductions by more than 20% (North-West PRadj=0.74; North East PRadj=0.70). Changes in the south occurred mostly between 2010 and 2015, whereas those in the north were more gradual and most continued after 2015. Recent changes were not correlated with survey-reported variation in use of preventive measures. Reductions in malaria infection in children under 5 have occurred in most individual states in Nigeria since 2010, but substantial geographical variation in the timing and extent indicate challenges to be overcome to enable global malaria reduction.
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DOI：
10.1016/s0140-6736(20)32227-3
发表时间：
2020-12-05
期刊：
Lancet (London, England)
影响因子：
--
作者：
ACCESS-SMC Partnership
通讯作者：
ACCESS-SMC Partnership
影响因子：
3.7
作者：
Ceesay, Serign J.;Casals-Pascual, Climent;Conway, David J.
通讯作者：
Conway, David J.
DOI：
10.1016/j.ijpddr.2016.08.004
发表时间：
2016-12
影响因子：
4
作者：
Oguike, Mary C.;Falade, Catherine O.;Shu, Elvis;Enato, Izehiuwa G.;Watila, Ismaila;Baba, Ebenezer S.;Bruce, Jane;Webster, Jayne;Hamade, Prudence;Meek, Sylvia;Chandramohan, Daniel;Sutherland, Colin J.;Warhurst, David;Roper, Cally
通讯作者：
Roper, Cally
影响因子：
9.4
作者：
Oyibo WA;Ezeigwe N;Ntadom G;Oladosu OO;Rainwater-Loveth K;O'Meara W;Okpokoro E;Brieger W
通讯作者：
Brieger W
DOI：
10.1093/cid/ciy870
发表时间：
2019-07-02
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Mwesigwa J;Achan J;Affara M;Wathuo M;Worwui A;Mohammed NI;Kanuteh F;Prom A;Dierickx S;di Tanna GL;Nwakanma D;Bousema T;Drakeley C;Van Geertruyden JP;D'Alessandro U
通讯作者：
D'Alessandro U