EPaT Team (EA3593), UFR de Médecine - Université des Antilles et de la Guyane, Cayenne, French Guiana.
Malar J. 2011 Aug 23;10:246. doi: 10.1186/1475-2875-10-246.
Malaria is a major health issue in French Guiana. Amerindian communities remain the most affected. A previous study in Camopi highlighted the predominant role of environmental factors in the occurrence of malaria. However, all parameters involved in the transmission were not clearly identified. A new survey was conducted in order to clarify the risk factors for the presence of malaria cases in Camopi.
An open cohort of children under seven years of age was set up on the basis of biologically confirmed malaria cases for the period 2001-2009. Epidemiological and observational environmental data were collected using two structured questionnaires. Data were analysed with a multiple failures multivariate Cox model. The influence of climate and the river level on malaria incidence was evaluated by time-series analysis. Relationships between Anopheles darlingi human biting rates and malaria incidence rates were estimated using Spearman's rank correlation.
The global annual incidence over the nine-year period was 238 per 1,000 for Plasmodium falciparum, 514 per 1,000 for Plasmodium visa and 21 per 1,000 for mixed infections. The multivariate survival analysis associated higher malaria incidence with living on the Camopi riverside vs. the Oyapock riverside, far from the centre of the Camopi hamlet, in a home with numerous occupants and going to sleep late. On the contrary, living in a house cleared of all vegetation within 50 m and at high distance of the forest were associated with a lower risk. Meteorological and hydrological characteristics appeared to be correlated with malaria incidence with different lags. Anopheles darlingi human biting rate was also positively correlated to incident malaria in children one month later.
Malaria incidence in children remains high in young children despite the appearance of immunity in children around three years of age. The closeness environment but also the meteorological parameters play an important role in malaria transmission among children under seven years of age in Camopi.
法属圭亚那的疟疾是一个主要的健康问题。美洲印第安人社区仍然是受影响最严重的社区。此前在卡莫皮进行的一项研究强调了环境因素在疟疾发生中的主要作用。然而，所有涉及传播的参数都没有被清楚地识别。为了澄清卡莫皮疟疾病例存在的危险因素，进行了一项新的调查。
根据 2001 年至 2009 年期间经生物证实的疟疾病例，建立了一个 7 岁以下儿童的开放队列。使用两份结构化问卷收集流行病学和观测环境数据。使用多元失败多变量 Cox 模型进行数据分析。通过时间序列分析评估气候和河流水位对疟疾发病率的影响。使用 Spearman 秩相关估计致倦库蚊人血叮刺率与疟疾发病率之间的关系。
在九年期间，总的年发病率为恶性疟原虫 238 例/1000，间日疟原虫 514 例/1000，混合感染 21 例/1000。多变量生存分析表明，与住在 Oyapock 河边相比，住在 Camopi 河边、远离 Camopi 村庄中心、居住在人口众多的家中且晚睡的人，疟疾发病率更高。相反，居住在距离森林 50 米以内且清除了所有植被的房屋中，与较低的风险相关。气象和水文特征似乎与疟疾发病率相关，具有不同的滞后。致倦库蚊人血叮刺率也与一个月后儿童发生的疟疾呈正相关。
尽管 3 岁左右的儿童出现了免疫力，但儿童的疟疾发病率仍居高不下。在 Camopi，儿童环境的接近程度以及气象参数在 7 岁以下儿童的疟疾传播中起着重要作用。
