Koram Kwadwo A, Owusu-Agyei Seth, Fryauff David J, Anto Francis, Atuguba Frank, Hodgson Abraham, Hoffman Stephen L, Nkrumah Francis K
Noguchi Memorial Institute for Medical Research, Legon, Accra, Ghana.
Trop Med Int Health. 2003 Sep;8(9):793-802. doi: 10.1046/j.1365-3156.2003.01092.x.
We conducted all-age point prevalence surveys to profile the severity and seasonality of malaria and anaemia in Kassena-Nankana District of northern Ghana. Random cross-sectional surveys were timed to coincide with the end of low (May 2001) and high (November 2001) malaria transmission seasons and to yield information as to the potential value of haemoglobin (Hb) levels and parasitaemia as markers of malaria morbidity and/or malaria vaccine effect. Parasitaemia was found in 22% (515 of 2286) screened in May (dry-low transmission), and in 61% of the general population (1026 of 1676) screened in November (wet-high transmission). Malaria prevalence in May ranged from 4% (infants <6 months and adults 50-60 years) to 54% (children 5-10 years). Age-specific malaria prevalence in November ranged from 38% (adults 50-60 years) to 82% (children 5-10 years). Differences between low- and high-transmission periods in the prevalence of severe anaemia (SA) among young children (6-24 months) were unexpectedly comparable (low, 3.9%vs. high, 5.4%; P = 0.52) and greatly reduced from levels measured in this same community and age group in November 2000 (12.5%) and November 1996 (22.0%). Despite the lower frequency of anaemia/SA in young children surveyed in 2001, it was still clear that this condition was strongly associated with parasitaemia and that children under 5 years of age experienced a significant drop in their mean Hb levels by the end of the high transmission season. Prevalence of parasitaemia was significantly lower (P < 0.01) among infants and young children (<2 years) whose parents reported the use of bednets. There was a significantly lower risk of parasitaemia among infants [odds ratio (OR) 6-8] and young children (OR 3-4) living in the central, more urbanized sector of the study area.
我们开展了全年龄段的现患率调查，以了解加纳北部卡塞纳-南卡纳区疟疾和贫血的严重程度及季节性情况。随机横断面调查的时间安排在疟疾低传播季（2001年5月）末和高传播季（2001年11月）末，旨在获取血红蛋白（Hb）水平和寄生虫血症作为疟疾发病率和/或疟疾疫苗效果标志物的潜在价值信息。5月（旱季-低传播期）筛查的2286人中，22%（515人）检测到寄生虫血症；11月（雨季-高传播期）筛查的普通人群中，61%（1676人中的1026人）检测到寄生虫血症。5月疟疾患病率从4%（6个月以下婴儿和50 - 60岁成年人）到54%（5 - 10岁儿童）不等。11月各年龄段疟疾患病率从38%（50 - 60岁成年人）到82%（5 - 10岁儿童）不等。幼儿（6 - 24个月）中重度贫血（SA）在低传播期和高传播期的患病率差异出乎意料地相近（低传播期为3.9%，高传播期为5.4%；P = 0.52），且与2000年11月和1996年11月在同一社区和年龄组测得的水平相比大幅降低（分别为12.5%和22.0%）。尽管2001年接受调查的幼儿贫血/SA发生率较低，但仍明显看出这种情况与寄生虫血症密切相关，且5岁以下儿童在高传播季末平均Hb水平显著下降。父母报告使用蚊帐的婴儿和幼儿（<2岁）中，寄生虫血症患病率显著较低（P < 0.01）。生活在研究区域中部城市化程度较高地区的婴儿[优势比（OR）为6 - 8]和幼儿（OR为3 - 4）感染寄生虫血症的风险显著较低。
