埃塞俄比亚奥罗米亚州和南方各族人民民族区域州的疟疾流行情况及蚊帐覆盖率
Malaria prevalence and mosquito net coverage in Oromia and SNNPR regions of Ethiopia.
作者信息
Shargie Estifanos B, Gebre Teshome, Ngondi Jeremiah, Graves Patricia M, Mosher Aryc W, Emerson Paul M, Ejigsemahu Yeshewamebrat, Endeshaw Tekola, Olana Dereje, WeldeMeskel Asrat, Teferra Admas, Tadesse Zerihun, Tilahun Abate, Yohannes Gedeon, Richards Frank O
机构信息
The Carter Center, Addis Ababa, Ethiopia.
出版信息
BMC Public Health. 2008 Sep 21;8:321. doi: 10.1186/1471-2458-8-321.
BACKGROUND
Malaria transmission in Ethiopia is unstable and seasonal, with the majority of the country's population living in malaria-prone areas. Results from DHS 2005 indicate that the coverage of key malaria interventions was low. The government of Ethiopia has set the national goal of full population coverage with a mean of 2 long-lasting insecticidal nets (LLINs) per household through distribution of about 20 million LLIN by the end of 2007. The aim of this study was to generate baseline information on malaria parasite prevalence and coverage of key malaria control interventions in Oromia and SNNPR and to relate the prevalence survey findings to routine surveillance data just before further mass distribution of LLINs.
METHODS
A 64 cluster malaria survey was conducted in January 2007 using a multi-stage cluster random sampling design. Using Malaria Indicator Survey Household Questionnaire modified for the local conditions as well as peripheral blood microscopy and rapid diagnostic tests, the survey assessed net ownership and use and malaria parasite prevalence in Oromia and SNNPR regions of Ethiopia. Routine surveillance data on malaria for the survey time period was obtained for comparison with prevalence survey results.
RESULTS
Overall, 47.5% (95% confidence interval (CI) 33.5-61.9%) of households had at least one net, and 35.1% (95% CI 23.1-49.4%) had at least one LLIN. There was no difference in net ownership or net utilization between the regions. Malaria parasite prevalence was 2.4% (95% CI 1.6-3.5%) overall, but differed markedly between the two regions: Oromia, 0.9% (95% CI 0.5-1.6); SNNPR, 5.4% (95% CI 3.4-8.5), p < 0.001. This difference between the two regions was also reflected in the routine surveillance data.
CONCLUSION
Household net ownership exhibited nearly ten-fold increase compared to the results of Demographic and Health Survey 2005 when fewer than 5% of households in these two regions owned any nets. The results of the survey as well as the routine surveillance data demonstrated that malaria continues to be a significant public health challenge in these regions-and more prevalent in SNNPR than in Oromia.
背景
埃塞俄比亚的疟疾传播不稳定且具有季节性，该国大部分人口生活在疟疾高发地区。2005年人口与健康调查（DHS）结果表明，关键疟疾干预措施的覆盖率较低。埃塞俄比亚政府设定了国家目标，即到2007年底通过分发约2000万顶长效驱虫蚊帐，实现每户平均拥有2顶长效驱虫蚊帐，从而覆盖全体人口。本研究的目的是收集奥罗米亚州和南方各族人民州疟疾寄生虫流行率以及关键疟疾控制干预措施覆盖率的基线信息，并在进一步大规模分发长效驱虫蚊帐之前，将流行率调查结果与常规监测数据相关联。
方法
2007年1月采用多阶段整群随机抽样设计进行了一项64个群组的疟疾调查。该调查使用针对当地情况修改的疟疾指标调查家庭问卷以及外周血显微镜检查和快速诊断检测，评估了埃塞俄比亚奥罗米亚州和南方各族人民州蚊帐的拥有和使用情况以及疟疾寄生虫流行率。获取了调查时间段内疟疾的常规监测数据，以便与流行率调查结果进行比较。
结果
总体而言，47.5%（95%置信区间（CI）33.5 - 61.9%）的家庭至少拥有一顶蚊帐，35.1%（95%CI 23.1 - 49.4%）的家庭至少拥有一顶长效驱虫蚊帐。各地区之间在蚊帐拥有率或蚊帐使用率方面没有差异。总体疟疾寄生虫流行率为2.4%（95%CI 1.6 - 3.5%），但两个地区之间存在显著差异：奥罗米亚州为0.9%（95%CI 0.5 - 1.6）；南方各族人民州为5.4%（95%CI 3.4 - 8.5），p < 0.001。两个地区之间的这种差异也反映在常规监测数据中。
结论
与2005年人口与健康调查结果相比，家庭蚊帐拥有率增长了近十倍，当时这两个地区拥有任何蚊帐的家庭不到5%。调查结果以及常规监测数据表明，疟疾在这些地区仍然是一个重大的公共卫生挑战，并且在南方各族人民州比在奥罗米亚州更为普遍。
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