Srivastava H C, Chandrashekar Pant, Kurien G, Sreehari U, Yadav R S
National Institute of Malaria Research, Feild Station, Civil Hospital, Nadiad-387 001 Gujarat, India.
Trop Biomed. 2011 Dec;28(3):638-45.
Malaria in migrant workers is always a major problem to control due to their temporary stay in shelters, and other operational constraints. Hence, a study was undertaken in brick kilns in Bharuch district, Gujarat state, India to study the problem of malaria in the work force. Mass blood surveys were carried out in 15 brick kilns. Blood slides were collected from both febrile and afebrile cases. Positive cases were treated as per the national drug policy and were followed up. Mosquito collections were carried out by pyrethrum spray collection in early morning hours. Human blood index and sporozoite rates were determined as per standard procedures. All age groups were found affected with malaria at brick kilns. Prevalence of malaria was significantly higher in ≤ 14 years of age-group as compared to adults. Post treatment follow up examination of patients revealed high malaria infection due to non-compliance of chloroquine. The appearance of parasitaemia among Plasmodium falciparum treated cases indicate the possibility of chloroquine resistance. The proportion of P. falciparum was >50% in migrant population. In stable population in villages, overall decline in malaria cases was observed in 2008-2010. The sporozoite rate of 4.2% in Anopheles culicifacies indicates active malaria transmission at brick kilns. The investigation demonstrated that suitable microclimatic conditions for malaria transmission exist in these areas during hottest period. The district health department should consider these factors in planning malaria surveillance and control. As current magnitude and diversity of population movements in rural as well as in urban areas are unprecedented, this issue is worthy of attention.
由于农民工在收容所临时居住以及其他操作限制因素，控制他们中的疟疾感染一直是个重大难题。因此，在印度古吉拉特邦巴鲁赫区的砖窑开展了一项研究，以调查劳动力中的疟疾问题。对15个砖窑进行了大规模血液调查。从发热和不发热病例中采集血涂片。阳性病例按照国家药物政策进行治疗并随访。清晨时分采用除虫菊酯喷雾法进行蚊虫采集。按照标准程序测定人体血液指数和子孢子率。发现砖窑中所有年龄组均受到疟疾影响。与成年人相比，≤14岁年龄组的疟疾患病率显著更高。患者治疗后的随访检查显示，由于氯喹不依从导致疟疾感染率很高。恶性疟原虫治疗病例中出现寄生虫血症表明存在氯喹耐药的可能性。流动人群中恶性疟原虫的比例>50%。在农村的稳定人群中，2008 - 2010年观察到疟疾病例总体下降。库氏按蚊的子孢子率为4.2%，表明砖窑存在活跃的疟疾传播。调查表明，在这些地区最炎热时期存在适合疟疾传播的微气候条件。地区卫生部门在规划疟疾监测和控制时应考虑这些因素。鉴于目前农村和城市地区人口流动的规模和多样性是前所未有的，这个问题值得关注。
