Epicentre Mbarara Research Base, Mbarara, Uganda.
Malar J. 2011 May 18;10:132. doi: 10.1186/1475-2875-10-132.
Malaria is a major public health problem, especially for children. However, recent reports suggest a decline in the malaria burden. The aim of this study was to assess the change in the prevalence of malaria infection among children below five years of age between 2004 and 2010 in a mesoendemic area of Uganda and to analyse the risk factors of malaria infection.
Two cross-sectional surveys were conducted in 2004 and in 2010 at the end of the rainy and dry seasons to measure the prevalence of P. falciparum infection among children less than five years of age. Rapid diagnostic tests and blood smears were used to diagnose malaria infection. In 2010, sampling was stratified by urban and rural areas. In each selected household, knowledge of malaria and bed nets, and bed net ownership and use, were assessed.
In 2004 and 2010, respectively, a total of 527 and 2,320 (999 in the urban area and 1,321 in rural areas) children less than five years old were enrolled. Prevalence of malaria infection declined from 43% (95% CI: 34-52) in 2004, to 23% (95% CI: 17-30) in rural areas in 2010 and 3% (95% CI: 2-5) in the urban area in 2010. From the rainy to dry season in 2010, prevalence decreased from 23% to 10% (95% CI: 6-14) in rural areas (P = 0.001) and remained stable from 3% to 4% (95% CI: 1-7) in the urban area (P = 0.9). The proportion of households reporting ownership and use of at least one bed net increased from 22.9% in 2004 to 64.7% in the urban area and 44.5% in rural areas in 2010 (P < 0.001). In 2010, the risk of malaria infection was consistently associated with child age and household wealth. In rural areas, malaria infection was also associated with geographic factors.
This study reports a significant drop in the prevalence of malaria infection among children below five years of age, paralleled by an uptake in bed-net use. However, prevalence remains unacceptably high in rural areas and is strongly associated with poverty.
疟疾是一个主要的公共卫生问题，尤其是对儿童而言。然而，最近的报告表明疟疾负担有所下降。本研究旨在评估乌干达中高度流行地区五岁以下儿童疟疾感染率在 2004 年至 2010 年期间的变化，并分析疟疾感染的危险因素。
2004 年和 2010 年在雨季和旱季末进行了两次横断面调查，以测量五岁以下儿童中恶性疟原虫感染的流行率。快速诊断测试和血涂片用于诊断疟疾感染。2010 年，采样按城乡分层。在每个选定的家庭中，评估了疟疾和蚊帐知识、蚊帐拥有率和使用率。
2004 年和 2010 年分别共纳入了 527 名和 2320 名（999 名来自城区，1321 名来自农村地区）五岁以下儿童。疟疾感染率从 2004 年的 43%（95%CI：34-52）下降到 2010 年农村地区的 23%（95%CI：17-30）和 2010 年城区的 3%（95%CI：2-5）。从 2010 年雨季到旱季，农村地区的患病率从 23%降至 10%（95%CI：6-14）（P = 0.001），城区的患病率从 3%稳定至 4%（95%CI：1-7）（P = 0.9）。报告至少拥有并使用一个蚊帐的家庭比例从 2004 年的 22.9%上升到 2010 年城区的 64.7%和农村地区的 44.5%（P<0.001）。2010 年，儿童年龄和家庭财富与疟疾感染风险呈一致性相关。在农村地区，疟疾感染还与地理因素有关。
本研究报告称，五岁以下儿童疟疾感染率显著下降，同时蚊帐使用率上升。然而，农村地区的患病率仍然高得不可接受，且与贫困密切相关。
