加纳库马西两个社区儿童中的疟疾与贫血：一项横断面调查
Malaria and anaemia among children in two communities of Kumasi, Ghana: a cross-sectional survey.
作者信息
Ronald Lisa A, Kenny Sarah L, Klinkenberg Eveline, Akoto Alex O, Boakye Isaac, Barnish Guy, Donnelly Martin J
机构信息
Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK.
出版信息
Malar J. 2006 Nov 9;5:105. doi: 10.1186/1475-2875-5-105.
BACKGROUND
A survey in Kumasi, Ghana found a marked Plasmodium falciparum prevalence difference between two neighbouring communities (Moshie Zongo and Manhyia). The primary objective of this follow-up study was to determine whether this parasite rate difference was consistent over time. Secondary objectives were to compare prevalences of clinical malaria, anaemia, intestinal parasite infections, and malnutrition between these communities; and to identify potential risk factors for P. falciparum infection and anaemia.
METHODS
A cross-sectional house-to-house survey of P. falciparum parasitaemia, clinical malaria, anaemia, anthropometric indices, and intestinal helminths was conducted in April-May 2005. Data collection included child and household demographics, mosquito avoidance practices, distance to nearest health facility, child's travel history, symptoms, and anti-malarial use. Risk factors for P. falciparum and anaemia (Hb < 11 g/dl) were identified using generalized linear mixed models.
RESULTS
In total, 296 children were tested from 184 households. Prevalences of P. falciparum, clinical malaria, anaemia, and stunting were significantly higher in Moshie Zongo (37.8%, 16.9%, 66.2% and 21.1%, respectively) compared to Manhyia (12.8%, 3.4%, 34.5% and 7.4%). Of 197 children tested for helminths, four were positive for Dicrocoelium dendriticum. Population attributable risks (PAR%) of anaemia were 16.5% (P. falciparum) and 7.6% (malnutrition). Risk factors for P. falciparum infection were older age, rural travel, and lower socioeconomic status. Risk factors for anaemia were P. falciparum infection, Moshie Zongo residence, male sex, and younger age.
CONCLUSION
Heterogeneities in malariometric indices between neighbouring Kumasi communities are consistent over time. The low helminth prevalence, and the twofold higher PAR% of anaemia attributable to P. falciparum infection compared to malnutrition, indicate the importance of malaria as a cause of anaemia in this urban population.
背景
在加纳库马西进行的一项调查发现，两个相邻社区（莫希宗戈和曼希亚）之间的恶性疟原虫流行率存在显著差异。这项随访研究的主要目的是确定这种寄生虫率差异是否随时间保持一致。次要目的是比较这些社区之间临床疟疾、贫血、肠道寄生虫感染和营养不良的患病率；并确定恶性疟原虫感染和贫血的潜在危险因素。
方法
2005年4月至5月，对恶性疟原虫血症、临床疟疾、贫血、人体测量指标和肠道蠕虫进行了逐户横断面调查。数据收集包括儿童和家庭人口统计学、防蚊措施、到最近医疗机构的距离、儿童旅行史、症状和抗疟药使用情况。使用广义线性混合模型确定恶性疟原虫和贫血（血红蛋白<11 g/dl）的危险因素。
结果
总共对来自184户家庭的296名儿童进行了检测。与曼希亚（分别为12.8%、3.4%、34.5%和7.4%）相比，莫希宗戈的恶性疟原虫、临床疟疾、贫血和发育迟缓患病率显著更高（分别为37.8%、16.9%、66.2%和21.1%）。在197名接受蠕虫检测的儿童中，有4名枝双腔吸虫呈阳性。贫血的人群归因风险（PAR%）分别为16.5%（恶性疟原虫）和7.6%（营养不良）。恶性疟原虫感染的危险因素是年龄较大、前往农村地区以及社会经济地位较低。贫血的危险因素是恶性疟原虫感染、居住在莫希宗戈、男性性别和年龄较小。
结论
库马西相邻社区之间的疟疾指标异质性随时间保持一致。蠕虫患病率较低，与营养不良相比，因恶性疟原虫感染导致的贫血PAR%高出两倍，这表明疟疾作为该城市人口贫血原因的重要性。
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