Heterogeneous decrease in malaria prevalence in children over a six-year period in south-western Uganda
Heterogeneous decrease in malaria prevalence in children over a six-year period in south-western Uganda
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DOI：
10.1186/1475-2875-10-132
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发表时间：
2011-05-18
期刊：
影响因子：
3
通讯作者：
Etard, Jean-Francois
中科院分区：
文献类型：
--
作者：
De Beaudrap, Pierre;Nabasumba, Carolyn;Etard, Jean-Francois
背景：疟疾是一个主要的公共卫生问题，特别是对儿童。然而，最近的报告表明，疟疾负担有所下降。本研究的目的是评估2004年至2010年乌干达中流行区5岁以下儿童疟疾感染率的变化，并分析疟疾感染的危险因素。方法：两个交叉-在2004年和2010年雨季和旱季结束时进行了断面调查，以测量五岁以下儿童。使用快速诊断测试和血涂片来诊断疟疾感染。2010年，抽样按城市和农村地区分层。结果：2004年和2010年，分别有527名和2，320名（城市地区999名，农村地区1，321名）5岁以下的儿童入学。疟疾感染率从2004年的43%（95%可信区间：34-52）降至2010年农村地区的23%（95%可信区间：17-30）和城市地区的3%（95%可信区间：2-5）。从2010年雨季到旱季，农村地区的患病率从23%降至10%（95%CI：6-14）（P = 0.001），城市地区保持稳定，从3%降至4%（95%CI：1-7）（P = 0.9）。报告拥有和使用至少一顶蚊帐的家庭比例从2004年的22.9%增加到2010年的城市地区64.7%和农村地区44.5%（P < 0.001）。2010年，疟疾感染风险始终与儿童年龄和家庭财富有关。在农村地区，疟疾感染也与地理factors.Conclusions：这项研究报告了显着下降，疟疾感染的患病率在5岁以下的儿童中，吸收蚊帐的使用。然而，农村地区的流行率仍然高得令人无法接受，并且与贫困密切相关。
Background: Malaria is a major public health problem, especially for children. However, recent reports suggest a decline in the malaria burden. The aim of this study was to assess the change in the prevalence of malaria infection among children below five years of age between 2004 and 2010 in a mesoendemic area of Uganda and to analyse the risk factors of malaria infection.Methods: Two cross-sectional surveys were conducted in 2004 and in 2010 at the end of the rainy and dry seasons to measure the prevalence of P. falciparum infection among children less than five years of age. Rapid diagnostic tests and blood smears were used to diagnose malaria infection. In 2010, sampling was stratified by urban and rural areas. In each selected household, knowledge of malaria and bed nets, and bed net ownership and use, were assessed.Results: In 2004 and 2010, respectively, a total of 527 and 2,320 (999 in the urban area and 1,321 in rural areas) children less than five years old were enrolled. Prevalence of malaria infection declined from 43% (95% CI: 34-52) in 2004, to 23% (95% CI: 17-30) in rural areas in 2010 and 3% (95% CI: 2-5) in the urban area in 2010. From the rainy to dry season in 2010, prevalence decreased from 23% to 10% (95% CI: 6-14) in rural areas (P = 0.001) and remained stable from 3% to 4% (95% CI: 1-7) in the urban area (P = 0.9). The proportion of households reporting ownership and use of at least one bed net increased from 22.9% in 2004 to 64.7% in the urban area and 44.5% in rural areas in 2010 (P < 0.001). In 2010, the risk of malaria infection was consistently associated with child age and household wealth. In rural areas, malaria infection was also associated with geographic factors.Conclusions: This study reports a significant drop in the prevalence of malaria infection among children below five years of age, paralleled by an uptake in bed-net use. However, prevalence remains unacceptably high in rural areas and is strongly associated with poverty.