尼日利亚中北部乔斯市初级卫生保健中心就诊的5岁以下发热儿童疟疾寄生虫血症患病率及相关因素

Prevalence of malaria parasitaemia and associated factors in febrile under-5 children seen in Primary Health Care Centres in Jos, North Central Nigeria.

作者信息

Ikeh E I, Teclaire Ngo-Ndomb

机构信息

Department of Medical Microbiology, Faculty of Medical Sciences, University of Jos, Jos, Nigeria.

出版信息

Niger Postgrad Med J. 2008 Jun;15(2):65-9.

PMID:18575475

Abstract

OBJECTIVE

This study was carried out to determine the prevalence of malaria in febrile under-5 children attending Primary Health Care Centres in relation to some demographic factors, duration of symptoms, previous antimalarial intake, presence of pyrexia, exclusive breast-feeding, mid upper arm circumference and body temperature.

METHODS

Giemsa-stained thick and thin blood films prepared from blood specimens of 260 febrile under-5 children selected randomly from 5 Primary Health Care Centres in Jos, North Central Nigeria were examined microscopically for malaria parasite.

RESULTS

A prevalence of 56.9% was recorded in this study, and only Plasmodium falciparum was encountered. Educational status of their mothers is high as only 3.8% are illiterates. Duration of illness before the visit to the centres lasted from 1 day (12.3%) to 4 days representing 39.2%. Fever, malaise, vomiting and diarrhoea are the clinical symptoms found in the patients. Majority of the patients were infants (0-12 months) representing 53.1% of the screened population and had a malaria prevalence of 52.2%. The other age groups; 13-24, 25-36, 37-48 and 49-60 months recorded 57.1%, 63.6%, 81.8% and 75% respectively (P<0.05). The males recorded a prevalence of 57.9% as against 55.9% in female (P>0.05). Prevalence in relation to duration of symptoms was 64.9% for 3 days, while the least prevalence of 42.9% was for the 2 days' duration (P>0.05). Patients with no previous antimalarial intake had a prevalence of 56.8% while those with previous antimalarial intake recorded 57% (P>0.05). Patients who had pyrexia at the time of presentation had a prevalence of 56.3% as against 57.5% in those without pyrexia (P>0.05). Patients on exclusive breast feeding had 58.3% as against 42.6% in those not on exclusive breast feeding (P<0.05). Only 16 (6.2%) of the patients had a MUAC of 12 cm and recorded the highest prevalence of 87.5%, 137 (52.7%) with a MUAC of 13-15 cm recorded 72.3%, while 107 (41.2%) with a MUAC of >15 cm had a malaria parasitaemia prevalence of 32.7% (P<0.05). Patients with body temperatures of 370 degrees C recorded the highest prevalence of 60.4%, while those with 37.1 degrees C-38 degrees C, 38.1 degrees C-39 degrees C and 39.1 degrees C-40 degrees C recorded prevalences of 60.2%, 55.6% and 23.1% respectively.

CONCLUSION

The presence of a high prevalence of malaria parasitaemia in very vulnerable under-5 children in an urban centre calls for an urgent and serious implementation of various control measures against malaria; so as to reduce the sequelae and complications associated with this infection. The cause of fever in the absence of identifiable malaria parasite suggests that other infectious agents might be responsible for the pyrexia.

摘要

目的

本研究旨在确定在初级卫生保健中心就诊的5岁以下发热儿童中疟疾的流行情况，并探讨其与一些人口统计学因素、症状持续时间、既往抗疟药服用情况、发热情况、纯母乳喂养、上臂中部周长和体温的关系。

方法

从尼日利亚中北部乔斯市的5个初级卫生保健中心随机选取260名5岁以下发热儿童的血样，制备吉姆萨染色的厚薄血涂片，显微镜检查疟原虫。

结果

本研究中疟疾患病率为56.9%，仅发现恶性疟原虫。其母亲的教育程度较高，文盲率仅为3.8%。就诊前疾病持续时间从1天（12.3%）到4天，占39.2%。发热、不适、呕吐和腹泻是患者的临床症状。大多数患者为婴儿（0 - 12个月），占筛查人群的53.1%，疟疾患病率为52.2%。其他年龄组；13 - 24、25 - 36、37 - 48和49 - 60个月的患病率分别为57.1%、63.6%、81.8%和75%（P<0.05）。男性患病率为57.9%，女性为55.9%（P>0.05）。症状持续3天的患病率为64.9%，而持续2天的患病率最低，为42.9%（P>0.05）。既往未服用抗疟药的患者患病率为56.8%，既往服用抗疟药的患者患病率为57%（P>0.05）。就诊时发热的患者患病率为56.3%，无发热的患者患病率为57.5%（P>0.05）。纯母乳喂养的患者患病率为58.3%，非纯母乳喂养的患者患病率为42.6%（P<0.05）。只有16名（6.2%）患者的上臂中部周长为12厘米，患病率最高，为87.5%；137名（52.7%）上臂中部周长为13 - 15厘米的患者患病率为72.3%，而107名（41.2%）上臂中部周长大于15厘米的患者疟疾寄生虫血症患病率为32.7%（P<0.05）。体温为37.0摄氏度的患者患病率最高，为60.4%，而体温为37.1 - 38.0摄氏度、38.1 - 39.0摄氏度和39.1 - 40.0摄氏度的患者患病率分别为60.2%、55.6%和23.1%。