International Emerging Infections Program-Kenya, Centers for Disease Control and Prevention-Nairobi and Kisumu, Nairobi and Kisumu, Kenya.
PLoS One. 2011 Jan 18;6(1):e16085. doi: 10.1371/journal.pone.0016085.
Characterizing infectious disease burden in Africa is important for prioritizing and targeting limited resources for curative and preventive services and monitoring the impact of interventions.
From June 1, 2006 to May 31, 2008, we estimated rates of acute lower respiratory tract illness (ALRI), diarrhea and acute febrile illness (AFI) among >50,000 persons participating in population-based surveillance in impoverished, rural western Kenya (Asembo) and an informal settlement in Nairobi, Kenya (Kibera). Field workers visited households every two weeks, collecting recent illness information and performing limited exams. Participants could access free high-quality care in a designated referral clinic in each site. Incidence and longitudinal prevalence were calculated and compared using Poisson regression.
INCIDENCE RATES RESULTING IN CLINIC VISITATION WERE THE FOLLOWING: ALRI--0.36 and 0.51 episodes per year for children <5 years and 0.067 and 0.026 for persons ≥ 5 years in Asembo and Kibera, respectively; diarrhea--0.40 and 0.71 episodes per year for children <5 years and 0.09 and 0.062 for persons ≥ 5 years in Asembo and Kibera, respectively; AFI--0.17 and 0.09 episodes per year for children <5 years and 0.03 and 0.015 for persons ≥ 5 years in Asembo and Kibera, respectively. Annually, based on household visits, children <5 years in Asembo and Kibera had 60 and 27 cough days, 10 and 8 diarrhea days, and 37 and 11 fever days, respectively. Household-based rates were higher than clinic rates for diarrhea and AFI, this difference being several-fold greater in the rural than urban site.
Individuals in poor Kenyan communities still suffer from a high burden of infectious diseases, which likely hampers their development. Urban slum and rural disease incidence and clinic utilization are sufficiently disparate in Africa to warrant data from both settings for estimating burden and focusing interventions.
描述非洲传染病负担对优先考虑和针对有限的治疗和预防服务资源以及监测干预措施的影响至关重要。
2006 年 6 月 1 日至 2008 年 5 月 31 日，我们在肯尼亚西部贫困农村地区（Asembo）和内罗毕的一个非正式定居点（Kibera）进行了基于人群的监测，对超过 50000 人估计了急性下呼吸道疾病（ALRI）、腹泻和急性发热性疾病（AFI）的发病率。现场工作人员每两周访问一次家庭，收集近期疾病信息并进行有限的检查。参与者可以在每个地点的指定转诊诊所获得免费的高质量护理。使用泊松回归计算发病率和纵向患病率，并进行比较。
导致就诊的发病率如下：ALRI-5 岁以下儿童为每年 0.36 和 0.51 次，5 岁以上儿童为每年 0.067 和 0.026 次；腹泻-5 岁以下儿童为每年 0.40 和 0.71 次，5 岁以上儿童为每年 0.09 和 0.062 次；AFI-5 岁以下儿童为每年 0.17 和 0.09 次，5 岁以上儿童为每年 0.03 和 0.015 次。基于家访，每年，Asembo 和 Kibera 的 5 岁以下儿童分别有 60 次和 27 次咳嗽日、10 次和 8 次腹泻日、37 次和 11 次发热日。腹泻和 AFI 的家庭发病率高于诊所发病率，农村地区的差异是城市地区的数倍。
肯尼亚贫困社区的个人仍然面临着高传染病负担，这可能会阻碍他们的发展。非洲城市贫民窟和农村地区的发病率和诊所利用率差异很大，因此需要来自这两个地区的数据来估计负担并集中干预措施。
