Lekana-Douki Jean-Bernard, Pontarollo Julie, Zatra Rafika, Toure-Ndouo Fousseyni S
Centre International de Recherches Médicales de Franceville, Unité de Parasitologie Médicale, BP 769 Franceville Gabon.
Sante. 2011 Oct-Dec;21(4):193-8. doi: 10.1684/san.2011.0263.
Despite progress in the control of malaria, it remains a serious public health problem. Substantial declines in malaria transmission, morbidity and mortality have nonetheless been reported in several countries where new malaria control strategies have been implemented. We conducted this molecular and epidemiological analysis of malaria in the pediatric department of the Chinese-Gabon Friendship Hospital (HCGC) in Franceville in 2010. Franceville is the third largest town in Gabon, and malaria transmission is high year-round. We included 945 children, 756 of them febrile. Malaria was diagnosed based on the detection of P. falciparum in thick blood films, with Lambarene's method. Malaria prevalence among the febrile children included in this study was 17.9% (n=135). The burden of malaria is thus lower than in the past; it is now the second leading cause of pediatric hospital visits, rather than the leading cause as it was in 2004. The children's mean age was 48.5 ± 3.9 months, older than in 2004 (p<0.05). We also analysed the molecular drug resistance marker, Pfmdr1. The prevalence of the wild-type genotype N86 of Pfmdr1 was 47.4% (n=64), higher than in 2004 (p<0.001). The increased prevalence of codon 1246 was not significant. Socio-economic factors and known malaria risk factors were analysed. We found that the use of Insecticide-treated mosquito nets and the provision of information (education or communication) to parents and guardians about malaria were protective factors against the disease. In conclusion, a larger study of the entire region over a longer period is necessary to characterise malaria in Franceville today. Transmission factors must also be studied.
尽管在疟疾控制方面取得了进展，但它仍然是一个严重的公共卫生问题。然而，在一些实施了新的疟疾控制策略的国家，已报告疟疾传播、发病率和死亡率大幅下降。2010年，我们在法国维尔的中加友谊医院（HCGC）儿科对疟疾进行了这项分子和流行病学分析。法国维尔是加蓬第三大城镇，全年疟疾传播率很高。我们纳入了945名儿童，其中756名发热。根据厚血膜中恶性疟原虫的检测结果，采用兰巴雷内方法诊断疟疾。本研究中纳入的发热儿童疟疾患病率为17.9%（n = 135）。因此，疟疾负担低于过去；它现在是儿科住院就诊的第二大主要原因，而不是2004年时的首要原因。儿童的平均年龄为48.5±3.9个月，比2004年时大（p<0.05）。我们还分析了分子耐药标志物Pfmdr1。Pfmdr1野生型基因型N86的患病率为47.4%（n = 64），高于2004年（p<0.001）。密码子1246患病率的增加并不显著。我们分析了社会经济因素和已知的疟疾风险因素。我们发现，使用经杀虫剂处理的蚊帐以及向家长和监护人提供有关疟疾的信息（教育或宣传）是预防该疾病的保护因素。总之，有必要在更长时间内对整个地区进行更大规模的研究，以描述当今法国维尔的疟疾情况。还必须研究传播因素。
