Ghebreyesus T A, Haile M, Witten K H, Getachew A, Yohannes M, Lindsay S W, Byass P
Tigray Health Bureau, Mekelle, Ethiopia.
Trans R Soc Trop Med Hyg. 2000 Jan-Feb;94(1):17-21. doi: 10.1016/s0035-9203(00)90424-3.
Malaria transmission varies from village to village and even from family to family in the same village. The current study was conducted in northern Ethiopia to identify risk factors responsible for such variations in a hypoendemic highland malaria setting: 2114 children aged < 10 years living in 6 villages situated close to small dams at altitudes from 1775 to 2175 m were monitored. Monthly malaria incidence was determined 4 times over a 1-year period during 1997. Incidence results were then analysed by 14 individual and household factors using Poisson multivariate regression. Among 14 factors analysed, use of irrigated land (rate ratio[RR] = 2.68, 95% CI 1.64-4.38), earth roof (RR = 2.15, 95% CI 1.31-3.52), animals sleeping in the house (RR = 1.92, 95% CI 1.29-2.85), windows (RR = 1.84, 95% CI 1.30-2.63), open eaves (RR = 1.85, 95% CI 1.19-2.88), no separate kitchen (RR = 1.57, 95% CI 1.10-2.23), and 1 sleeping room (RR = 1.52, 95% CI 1.05-2.20), were significantly associated with malaria. The proportion of infection among children exposed to one or no risk factor was 2.1%, increasing with the number of risk factors and reaching 29.4% with 5 or more. Further studies are needed to confirm the importance of particular risk factors, possibly leading to simple health education and control measures that could become part of routine control programmes, implemented with inter-sectoral collaboration.
疟疾传播在不同村庄之间存在差异，甚至在同一村庄内的不同家庭之间也有所不同。当前的研究在埃塞俄比亚北部开展，旨在确定在低流行的高原疟疾环境中造成这种差异的风险因素：对居住在海拔1775至2175米、靠近小型水坝的6个村庄中的2114名10岁以下儿童进行了监测。在1997年的1年时间里，每月测定4次疟疾发病率。然后使用泊松多元回归分析发病率结果与14个个体和家庭因素之间的关系。在分析的14个因素中，使用灌溉土地（率比[RR]=2.68，95%可信区间1.64 - 4.38）、泥土屋顶（RR = 2.15，95%可信区间1.31 - 3.52）、动物在屋内睡觉（RR = 1.92，95%可信区间1.29 - 2.85）、窗户（RR = 1.84，95%可信区间1.30 - 2.63）、开放式屋檐（RR = 1.85，95%可信区间1.19 - 2.88）、没有独立厨房（RR = 1.57，95%可信区间1.10 - 2.23）以及1个卧室（RR = 1.52，95%可信区间1.05 - 2.20）与疟疾显著相关。暴露于1个或没有风险因素的儿童中感染比例为2.1%，随着风险因素数量的增加而上升，5个或更多风险因素时达到29.4%。需要进一步研究以确认特定风险因素的重要性，这可能会促成简单的健康教育和控制措施，这些措施可成为常规控制项目的一部分，并通过部门间合作来实施。
