在老挝农村地区，使用经杀虫剂处理过的蚊帐的情况下，在农舍过夜是否会增加疟疾感染的风险？
Is staying overnight in a farming hut a risk factor for malaria infection in a setting with insecticide-treated bed nets in rural Laos?
机构信息
Department of Community and Global Health, Graduate School of Medicine, the University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, Japan.
出版信息
Malar J. 2010 Dec 23;9:372. doi: 10.1186/1475-2875-9-372.
BACKGROUND
Overnight stays in farming huts are known to pose a risk of malaria infection. However, studies reporting the risk were conducted in the settings of poor net coverage. This study sought to assess whether an overnight stay in a farming hut is associated with an increased risk of malaria infection if insecticide-treated bed nets (ITNs) are properly used.
METHODS
A pair of cross-sectional surveys was carried out in the Lamarm district of Sekong province, Laos, in March (dry season) and August (rainy season) in 2008. Questionnaire-based interviews and blood examinations were conducted with farmers and their household members from three randomly selected villages in March (127 households, 891 people) and August (128 households, 919 people). Logistic regression analysis, adjusted for potential confounding factors, was used to assess the association between malaria infection status and frequency of overnight stays for the two weeks prior to the study in both the seasons.
RESULTS
In March, 13.7% of participants reported staying overnight in a farming hut at least once in the previous two weeks. The percentage increased to 74.6% in August. Not only adults but also young children stayed overnight as often as adults. The use of an ITN the preceding night was common both in farming huts (66.3% in March, 95.2% in August), and in main residences (85.8% in March, 92.5% in August). Logistic regression analysis showed no statistical association between malaria infection status and frequency of overnight stays in farming huts in either study period. However, people sharing one family type net with five people or more were significantly more likely to have malaria than those sharing a net with up to two people in the dry season.
CONCLUSIONS
This study showed that staying overnight in farming huts was not associated with an increased risk of malaria infection in the setting where ITNs were widely used in farming huts. It suggests that malaria infection during overnight stays in farming huts might be preventable if ITNs are properly used in rural Laos.
背景
众所周知，在农舍过夜会有感染疟疾的风险。然而，进行这些研究的地点往往是蚊帐覆盖率较低的地区。本研究旨在评估如果妥善使用经杀虫剂处理的蚊帐（ITN），在农舍过夜是否会增加感染疟疾的风险。
方法
2008 年 3 月（旱季）和 8 月（雨季）在老挝色贡省的拉玛姆区进行了两项横断面调查。3 月份（127 户，891 人）和 8 月份（128 户，919 人），从三个随机选择的村庄中对农民及其家庭成员进行了基于问卷调查的访谈和血液检查。使用逻辑回归分析，调整潜在混杂因素后，评估两个季节中在研究前两周内疟疾感染状况与过夜频率之间的关联。
结果
3 月份，13.7%的参与者报告在前两周内至少有一次在农舍过夜。这一比例在 8 月份增加到 74.6%。不仅成年人，而且年幼的孩子也像成年人一样经常在农舍过夜。前一天晚上使用 ITN 在农舍（3 月份 66.3%，8 月份 95.2%）和主要住所（3 月份 85.8%，8 月份 92.5%）都很常见。逻辑回归分析显示，在两个研究期间，疟疾感染状况与在农舍过夜的频率之间均无统计学关联。然而，在旱季，与使用人数不超过两人的人相比，与五人或五人以上的人共用一个家庭类型的蚊帐的人更有可能感染疟疾。
结论
本研究表明，在广泛使用 ITN 的环境中，在农舍过夜与感染疟疾的风险增加无关。这表明，如果在老挝农村妥善使用 ITN，在农舍过夜时感染疟疾是可以预防的。
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