African Population and Health Research Centre, Nairobi, Kenya.
Malar J. 2009 Jul 15;8:160. doi: 10.1186/1475-2875-8-160.
In sub-Saharan Africa, knowledge of malaria transmission across rapidly proliferating urban centres and recommendations for its prevention or management remain poorly defined. This paper presents the results of an investigation into infection prevalence and treatment of recent febrile events among a slum population in Nairobi, Kenya.
In July 2008, a community-based malaria parasite prevalence survey was conducted in Korogocho slum, which forms part of the Nairobi Urban Health and Demographic Surveillance system. Interviewers visited 1,069 participants at home and collected data on reported fevers experienced over the preceding 14 days and details on the treatment of these episodes. Each participant was tested for malaria parasite presence with Rapid Diagnostic Test (RDT) and microscopy. Descriptive analyses were performed to assess the period prevalence of reported fever episodes and treatment behaviour.
Of the 1,069 participants visited, 983 (92%) consented to be tested. Three were positive for Plasmodium falciparum using RDT; however, all were confirmed negative on microscopy. Microscopic examination of all 953 readable slides showed zero prevalence. Overall, from the 1,004 participants who have data on fever, 170 fever episodes were reported giving a relatively high period prevalence (16.9%, 95% CI:13.9%-20.5%) and higher among children below five years (20.1%, 95%CI:13.8%-27.8%). Of the fever episodes with treatment information 54.3% (95%CI:46.3%-62.2%) were treated as malaria using mainly sulphadoxine-pyrimethamine or amodiaquine, including those managed at a formal health facility. Only four episodes were managed using the nationally recommended first-line treatment, artemether-lumefantrine.
The study could not demonstrate any evidence of malaria in Korogocho, a slum in the centre of Nairobi. Fever was a common complaint and often treated as malaria with anti-malarial drugs. Strategies, including testing for malaria parasites to reduce the inappropriate exposure of poor communities to expensive anti-malarial drugs provided by clinical services and drug vendors, should be a priority for district planners.
在撒哈拉以南非洲，对迅速发展的城市中心的疟疾传播知识以及对其预防或管理的建议仍未得到明确界定。本文介绍了在内罗毕肯尼亚的一个贫民窟中，对贫民窟人群最近发热事件的感染率和治疗情况进行的一项调查结果。
2008 年 7 月，在内罗毕城市卫生和人口监测系统的 Korogocho 贫民窟进行了一项基于社区的疟疾寄生虫流行率调查。访谈员家访了 1069 名参与者，收集了他们在过去 14 天内报告的发热情况的数据以及这些发作的治疗情况。每位参与者都接受了快速诊断测试（RDT）和显微镜检查，以检查是否存在疟原虫。进行描述性分析以评估报告发热发作的时期流行率和治疗行为。
在接受家访的 1069 名参与者中，有 983 名（92%）同意接受检测。使用 RDT 检查发现有 3 人感染恶性疟原虫，但所有病例在显微镜检查中均为阴性。对所有 953 张可读载玻片进行显微镜检查，结果均为零感染率。总体而言，从有发热数据的 1004 名参与者中，有 170 例发热发作，这导致了相对较高的时期流行率（16.9%，95%CI：13.9%-20.5%），五岁以下儿童的流行率更高（20.1%，95%CI：13.8%-27.8%）。在有治疗信息的发热发作中，有 54.3%（95%CI：46.3%-62.2%）被用作疟疾治疗，主要使用磺胺多辛-乙胺嘧啶或阿莫地喹，包括在正规医疗机构进行的治疗。仅有 4 例发作使用了国家推荐的一线治疗药物，青蒿琥酯-阿莫地喹。
该研究无法在内罗毕中心的贫民窟 Korogocho 中证明有任何疟疾证据。发热是常见的投诉，通常用抗疟药物治疗。对于疟疾的治疗，应优先考虑制定策略，包括检测疟原虫，以减少贫困社区不必要地接触昂贵的临床服务和药品供应商提供的抗疟药物。
