Prevalence and risk factors of malaria among children in southern highland Rwanda.
Prevalence and risk factors of malaria among children in southern highland Rwanda.
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DOI：
10.1186/1475-2875-10-134
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发表时间：
2011-05-18
期刊：
影响因子：
3
通讯作者：
Mockenhaupt FP
中科院分区：
文献类型：
--
作者：
Gahutu JB;Steininger C;Shyirambere C;Zeile I;Cwinya-Ay N;Danquah I;Larsen CH;Eggelte TA;Uwimana A;Karema C;Musemakweri A;Harms G;Mockenhaupt FP
在撒哈拉以南非洲的一些地区，包括卢旺达，加强控制使疟疾显著减少。2010年初，在靠近布塔雷县首府的南部高地（海拔1,768米），开展了一项基于社区和设施的疟原虫感染联合调查。总共检查了749名5岁以下儿童，包括从24个村庄随机抽取的545名儿童，103名在主管保健中心就诊，101名在转诊地区医院就诊。收集了临床、寄生虫学、血液学和社会经济数据。镜检和PCR检出恶性疟原虫感染，分别占11.7%和16.7%，平均感染数为2.08；5.5%的儿童患有疟疾。基于聚合酶链反应的恶性疟原虫流行率在村庄为0 - 38.5%，在卫生中心为21.4%，在医院为14.9%。感染的独立预测因素包括年龄增加、中上臂围低、缺乏几项家庭资产、报告最近摄入蒿甲醚-氨苯曲明和血浆氯喹（ELISA测定）。仅在单变量分析中，自我报告的蚊帐使用（58%）减少了感染。在社区中，大多数感染看似无症状，但在有和没有寄生虫血症的儿童中分别有82%和28%观察到贫血，这种影响随着寄生虫密度的增加而增加，亚显微镜感染也很显著。在卢旺达布塔雷周围的高地，每6名5岁以下儿童中就有1人感染恶性疟原虫。社区中大量看似无症状的感染形成了在这一流行病易发地区传播的水库。表明社会经济地位低下和自我报告蚊帐使用有效性不足的风险因素涉及可改进干预的领域。
Increased control has produced remarkable reductions of malaria in some parts of sub-Saharan Africa, including Rwanda. In the southern highlands, near the district capital of Butare (altitude, 1,768 m), a combined community-and facility-based survey on Plasmodium infection was conducted early in 2010. A total of 749 children below five years of age were examined including 545 randomly selected from 24 villages, 103 attending the health centre in charge, and 101 at the referral district hospital. Clinical, parasitological, haematological, and socio-economic data were collected. Plasmodium falciparum infection (mean multiplicity, 2.08) was identified by microscopy and PCR in 11.7% and 16.7%, respectively; 5.5% of the children had malaria. PCR-based P. falciparum prevalence ranged between 0 and 38.5% in the villages, and was 21.4% in the health centre, and 14.9% in the hospital. Independent predictors of infection included increasing age, low mid-upper arm circumference, absence of several household assets, reported recent intake of artemether-lumefantrine, and chloroquine in plasma, measured by ELISA. Self-reported bed net use (58%) reduced infection only in univariate analysis. In the communities, most infections were seemingly asymptomatic but anaemia was observed in 82% and 28% of children with and without parasitaemia, respectively, the effect increasing with parasite density, and significant also for submicroscopic infections. Plasmodium falciparum infection in the highlands surrounding Butare, Rwanda, is seen in one out of six children under five years of age. The abundance of seemingly asymptomatic infections in the community forms a reservoir for transmission in this epidemic-prone area. Risk factors suggestive of low socio-economic status and insufficient effectiveness of self-reported bed net use refer to areas of improvable intervention.
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影响因子：
3.3
作者：
Müller, O;Garenne, M;Becher, H
通讯作者：
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影响因子：
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Ghani, Azra C.
DOI：
10.1016/s0035-9203(96)90482-4
发表时间：
1996-01-01
影响因子：
2.2
作者：
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通讯作者：
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影响因子：
15.8
作者：
Guerra, Carlos A.;Gikandi, Priscilla W.;Tatem, Andrew J.;Noor, Abdisalan M.;Smith, Dave L.;Hay, Simon I.;Snow, Robert W.
通讯作者：
Snow, Robert W.
DOI：
10.1016/s0140-6736(03)13366-1
发表时间：
2003-05-17
期刊：
Lancet (London, England)
影响因子：
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作者：
Hay SI;Were EC;Renshaw M;Noor AM;Ochola SA;Olusanmi I;Alipui N;Snow RW
通讯作者：
Snow RW