Epidemiological characterization of malaria in rural southern Tanzania following China-Tanzania pilot joint malaria control baseline survey
Epidemiological characterization of malaria in rural southern Tanzania following China-Tanzania pilot joint malaria control baseline survey
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DOI：
10.1186/s12936-018-2446-7
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发表时间：
2018-08-13
期刊：
影响因子：
3
通讯作者：
Abdullah, Salim
中科院分区：
文献类型：
--
作者：
Khatib, Rashid A.;Chaki, Prosper P.;Abdullah, Salim
背景：疟疾是坦桑尼亚的一个重要公共卫生问题。最新的全国疟疾数据表明，该国的疟疾疫情有所回升。阿拉伯按蚊是一种蚊子物种，以其对现有疟疾媒介控制措施的抵抗力而闻名，现在其数量已超过嗜食和慈善的冈比亚按蚊，成为主要媒介。病媒控制措施、预防措施和以青蒿素为基础的联合治疗(ACT)病例管理是主要的控制干预措施。本文介绍并讨论了在世界卫生组织结合中国疟疾控制经验的T3倡议试点之前进行的基线家庭调查的主要结果，该调查旨在确定疟疾寄生虫流行率和相关风险暴露，旨在进一步减少该地区的疟疾。方法：研究在坦桑尼亚南部Rufiji区的4个分区进行：Ikwiriri，Kibiti，Bungu和Chumbi。疟疾传播是该地区的地方病。它涉及从该地区登记的所有家庭名单中随机挑选的2000户家庭。对抽样家庭中的居民就一系列问题进行了访谈，其中包括访谈前一晚使用长效杀虫蚊帐和社会经济状况指标。血滴也采集在血片上，用显微镜检查疟疾寄生虫。结果：研究观察到选定地点疟疾寄生虫的平均流行率为13%。Ikwiriri区、Kibiti区、Bungu区和Chumbi区的感染率分别为5.6%、12.8%、16.7%和18%。在该地区发现的相应的LLIN用途占57.5%。Ikwiriri的使用率最高，为69.6%，而Bungu的使用率最低，为46.3%。从这项研究中观察到社会经济五分位数之间的寄生虫血症存在统计上的显著差异。讨论和结论：根据2015年至2016年坦桑尼亚人口与健康调查-疟疾指标调查和其他相关研究的结果，以及为疟疾控制设定的目标和指标，对调查结果进行了讨论。文章还讨论了观察到的寄生虫血症与LLIN使用报告的关系，以及从研究中探索的一些重要因素对其分布的影响。现已得出结论，疟疾负担目前集中在人口中最贫穷部分集中的定居点边缘，LLIN使用量低于国家和全球疟疾控制倡议设定的全国平均水平和目标。
Background: Malaria is an important public health problem in Tanzania. The latest national malaria data suggests rebound of the disease in the country. Anopheles arabiensis, a mosquito species renowned for its resilience against existing malaria vector control measures has now outnumbered the endophagic and anthrophilic Anopheles gambiae sensu stricto as the dominant vector. Vector control measures, prophylaxis and case management with artemisinin-based combination therapy (ACT) are the main control interventions. This paper presents and discusses the main findings from a baseline household survey that was conducted to determine malaria parasite prevalence and associated risk exposures prior to piloting the T3-initiative of World Health Organization integrated with Chinese malaria control experience aimed at additional reduction of malaria in the area.Methods: The study was conducted from 4 sub-district divisions in Rufiji District, southern Tanzania: lkwiriri, Kibiti, Bungu, and Chumbi. Malaria transmission is endemic in the area. It involved 2000 households that were randomly selected from a list of all households that had been registered from the area. Residents in sampled households were interviewed on a range of questions that included use of long-lasting insecticidal nets (LLINs) the night prior to the interview and indicators of socio-economic status. Blood drops were also collected on blood slides that were examined for malaria parasites using microscopes.Results: The study observed an average malaria parasite prevalence of 13% across the selected site. Its distribution was 5.6, 12.8, 16.7, and 18% from lkwiriri, Kibiti, Bungu, and Chumbi wards, respectively. The corresponding LLIN use discovered were 57.5% over the district. The highest usage was observed from Ikwiriri at 69.6% and the lowest from Bungu at 46.3%. A statistically significant variation in parasitaemia between socio-economic quintiles was observed from the study. Males were more parasitaemic than females (p value = 0.000).Discussion and conclusion: The findings have been discussed in the light of results from Tanzania Demographic and Health Survey-Malaria Indicator Survey, 2015-2016 and other related studies, together with goals and targets set for malaria control. The paper also discusses the observed parasitaemia in relation to reported LLIN use and its distribution by some important factors as they were explored from the study. It has been concluded that malaria burden is now concentrated on the fringes of the settlements where the poorest section of the population is concentrated and LLIN usage is lower than the national average and targets set by national and global malaria control initiatives.