Department of Pediatrics, University of Minnesota Medical School, Minneapolis 55414, USA.
Clin Infect Dis. 2012 Jan 15;54(2):178-84. doi: 10.1093/cid/cir768. Epub 2011 Nov 3.
Malaria control campaigns have reduced malaria transmission to very low levels in many areas of Africa. Yet the extent to which malaria interruption or elimination might decrease the prevalence of anemia in areas of low malaria transmission is unknown.
Kapsisiywa and Kipsamoite, highland areas of Kenya with low, unstable malaria transmission, experienced a 12-month interruption in malaria transmission from April 2007 to May 2008, following high-level coverage (>70% of households) with indoor residual insecticide spraying in 2007. Hemoglobin levels were tested in 1697 randomly selected asymptomatic residents of Kapsisiywa (n = 910) and Kipsamoite (n = 787) at the beginning of a 12-month period of interrupted transmission (in May 2007) and 14 months later (in July 2008).
From May 2007 to July 2008, only 1 of 1697 study cohort members developed clinical malaria. In this period, the prevalence of anemia decreased in Kapsisiywa in all age groups (from 57.5% to 37.9% in children aged <5 years [P < .001], from 21.7% to 10.5% in children aged 5-14 years [P < .001], and from 22.7% to 16.6% in individuals aged ≥ 15 years [P = .004]). The prevalence of anemia in Kipsamoite also decreased in children aged <5 years (from 47.2% to 31.3%; P = .001) but was unchanged in children aged 5-14 years and in individuals aged ≥15 years. Among children <5 years, anemia prevalence was reduced by 34% in both Kapsisiywa (95% confidence interval [CI], 21%-45%) and Kipsamoite (95% CI, 16%-48%).
Successful malaria elimination or interruption may lead to substantial reductions in anemia prevalence even in areas of very low transmission.
疟疾控制运动已经将许多非洲地区的疟疾传播降低到非常低的水平。然而，疟疾中断或消除在低疟疾传播地区降低贫血患病率的程度尚不清楚。
肯尼亚高地的卡普西维亚瓦和基帕萨莫伊特地区的疟疾传播水平低且不稳定，2007 年高覆盖率（超过 70%的家庭）进行室内残留杀虫剂喷洒后，于 2007 年 4 月至 2008 年 5 月经历了为期 12 个月的疟疾传播中断。在中断传播的 12 个月期间（2007 年 5 月）和 14 个月后（2008 年 7 月），对卡普西维亚瓦（n=910）和基帕萨莫伊特（n=787）1697 名无症状居民的随机样本进行了血红蛋白检测。
从 2007 年 5 月至 2008 年 7 月，研究队列的 1697 名成员中只有 1 人患有临床疟疾。在此期间，卡普西维亚瓦所有年龄段的贫血患病率均下降（<5 岁儿童从 57.5%降至 37.9%[P<0.001]，5-14 岁儿童从 21.7%降至 10.5%[P<0.001]，≥15 岁个体从 22.7%降至 16.6%[P=0.004]）。卡普西维亚瓦的<5 岁儿童贫血患病率也下降（从 47.2%降至 31.3%；P=0.001），但 5-14 岁儿童和≥15 岁个体的贫血患病率未发生变化。<5 岁儿童中，卡普西维亚瓦（95%置信区间[CI]，21%-45%）和基帕萨莫伊特（95%CI，16%-48%）的贫血患病率分别降低了 34%。
成功消除或中断疟疾传播可能会导致贫血患病率大幅降低，即使在传播水平非常低的地区也是如此。
