Shanks G D, Biomndo K, Guyatt H L, Snow R W
US Army Medical Research Unit-Kenya, Box 30137, Nairobi, Kenya.
Trans R Soc Trop Med Hyg. 2005 Jan;99(1):71-4. doi: 10.1016/j.trstmh.2004.04.001.
In the 1980s, highland malaria returned to the tea estates of western Kenya after an absence of nearly a generation. In order to determine the importance of travel for the spread of malaria in this region, we prospectively collected blood films and travel, demographic and geographic information on well persons and outpatients on tea estates near the western rim of the Rift Valley. Risk factors for malaria asexual parasitaemia included: tribal/ethnic group, home province and home district malaria endemicity. Travel away from the Kericho tea estates within the previous two months showed an odds ratio (OR) for parasitaemia of 1.59 for well persons and 2.38 for outpatients. Sexual stages of malaria parasites (gametocytes) had an OR of 3.14 (well persons) and 2.22 (outpatients) for those who had travelled. Increased risk of malaria parasitaemia with travel was concentrated in children aged <5 years. An increase in population gametocytaemia is possibly due to increased chloroquine resistance and suppressed infections contracted outside of the tea estates.
20世纪80年代，在消失了近一代人的时间后，高地疟疾又回到了肯尼亚西部的茶园。为了确定旅行对该地区疟疾传播的重要性，我们前瞻性地收集了裂谷西部边缘附近茶园中健康人和门诊患者的血片以及旅行、人口统计学和地理信息。疟疾无性寄生虫血症的危险因素包括：部落/种族群体、家乡省份和家乡地区的疟疾流行情况。在过去两个月内离开凯里乔茶园的人，健康人的寄生虫血症比值比（OR）为1.59，门诊患者为2.38。疟原虫的有性阶段（配子体），对于有旅行史的人，OR值健康人为3.14，门诊患者为2.22。疟疾寄生虫血症风险随旅行增加主要集中在5岁以下儿童。人群配子体血症增加可能是由于氯喹耐药性增加以及茶园外感染受到抑制。
