Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
Malar J. 2010 Jan 4;9:2. doi: 10.1186/1475-2875-9-2.
Malaria is a leading cause of disease burden in Uganda, although surprisingly few contemporary, age-stratified data exist on malaria epidemiology in the country. This report presents results from a total population survey of malaria infection and intervention coverage in a rural area of eastern Uganda, with a specific focus on how risk factors differ between demographic groups in this population.
In 2008, a cross-sectional survey was conducted in four contiguous villages in Mulanda, sub-county in Tororo district, eastern Uganda, to investigate the epidemiology and risk factors of Plasmodium species infection. All permanent residents were invited to participate, with blood smears collected from 1,844 individuals aged between six months and 88 years (representing 78% of the population). Demographic, household and socio-economic characteristics were combined with environmental data using a Geographical Information System. Hierarchical models were used to explore patterns of malaria infection and identify individual, household and environmental risk factors.
Overall, 709 individuals were infected with Plasmodium, with prevalence highest among 5-9 year olds (63.5%). Thin films from a random sample of 20% of parasite positive participants showed that 94.0% of infections were Plasmodium falciparum and 6.0% were P. malariae; no other species or mixed infections were seen. In total, 68% of households owned at least one mosquito although only 27% of school-aged children reported sleeping under a net the previous night. In multivariate analysis, infection risk was highest amongst children aged 5-9 years and remained high in older children. Risk of infection was lower for those that reported sleeping under a bed net the previous night and living more than 750 m from a rice-growing area. After accounting for clustering within compounds, there was no evidence for an association between infection prevalence and socio-economic status, and no evidence for spatial clustering.
These findings demonstrate that mosquito net usage remains inadequate and is strongly associated with risk of malaria among school-aged children. Infection risk amongst adults is influenced by proximity to potential mosquito breeding grounds. Taken together, these findings emphasize the importance of increasing net coverage, especially among school-aged children.
疟疾是乌干达的主要疾病负担原因，尽管令人惊讶的是，该国目前几乎没有关于疟疾流行病学的当代、按年龄分层的数据。本报告介绍了在乌干达东部一个农村地区进行的疟疾感染和干预措施覆盖范围的全人群调查结果，特别关注该人群中不同人群的风险因素有何不同。
2008 年，在乌干达东部托罗罗区姆兰达县的四个相邻村庄进行了一项横断面调查，以调查疟原虫种感染的流行病学和危险因素。邀请所有常住居民参加，从 6 个月至 88 岁的 1844 人（占人口的 78%）中采集血涂片。人口统计学、家庭和社会经济特征与环境数据一起使用地理信息系统进行组合。分层模型用于探索疟疾感染模式并确定个体、家庭和环境风险因素。
总体而言，709 人感染了疟原虫，5-9 岁年龄组的患病率最高（63.5%）。从随机抽取的 20%寄生虫阳性参与者的薄片中显示，94.0%的感染为恶性疟原虫，6.0%为间日疟原虫；未发现其他物种或混合感染。总的来说，68%的家庭拥有至少一个蚊帐，但只有 27%的学龄儿童报告前一天晚上睡在蚊帐下。在多变量分析中，5-9 岁的儿童感染风险最高，年龄较大的儿童风险仍然较高。前一天晚上睡在蚊帐下的人和居住在距离稻田 750 米以上的人感染的风险较低。在考虑到化合物内的聚类后，感染率与社会经济地位之间没有关联的证据，也没有空间聚类的证据。
这些发现表明，蚊帐的使用仍然不足，并且与学龄儿童患疟疾的风险密切相关。成人的感染风险受接近潜在蚊子滋生地的影响。总的来说，这些发现强调了增加蚊帐覆盖率的重要性，尤其是在学龄儿童中。
