Eyobo Margaret B, Awur Adwok C, Wani Gregory, Julla Ahmed I, Remijo Constantino D, Sebit Bakhit, Azairwe Robert, Thabo Othwonh, Bepo Edward, Lako Richard L, Riek Lul, Chanda Emmanuel
Ministry of Health, Juba, Republic of South Sudan.
Malar J. 2014 Feb 3;13:45. doi: 10.1186/1475-2875-13-45.
South Sudan has borne the brunt of years of chronic warfare and probably has the highest malaria burden in sub-Saharan Africa. Malaria is the leading cause of morbidity and mortality in the country. This nationally representative survey aimed to provide data on malaria indicators at household level across the country.
In 2009, data were collected using a two-stage random cluster sample of 2,797 households in 150 census enumeration areas during a Malaria Indicator Survey (MIS) in South Sudan. The survey determined parasite and anaemia prevalence in vulnerable population groups and evaluated coverage, use and access to malaria control services. Standardized Roll Back Malaria Monitoring and Evaluation Reference Group (RBM-MERG) MIS household and women's questionnaires were adapted to the local situation and used for collection of data that were analysed and summarized using descriptive statistics.
The results of this survey showed that 59.3% (95% CI: 57.5-61.1) of households owned at least one mosquito net. The proportion of the population with access to an ITN in their household was 49.7% (95% CI: 48.2-51.2). The utilization of insecticide-treated nets was low; 25.3% (95% CI: 23.9-26.7) for children under five (U5) and 35.9% (95% CI: 31.9-40.2) of pregnant women (OR: 1.66 (1.36-2.01); P =0.175). Prevalence of infection was 24.5% (95% CI: 23.0-26.1) in children U5 and 9.9% (95% CI: 7.4-13.1) in pregnant women. About two thirds (64%) of children U5 and 46% of pregnant women were anaemic. Only 2% of households were covered by indoor residual spraying (IRS) the previous year. Data shows that 58% reported that malaria is transmitted by mosquitoes, 34% mentioned that the use of mosquito nets could prevent malaria, 41% knew the correct treatment for malaria, and 52% of the children received treatment at a health facility.
The observed high malaria prevalence could be due to low levels of coverage and utilization of interventions coupled with low knowledge levels. Therefore, access and utilization of malaria control tools should be increased through scaling up coverage and improving behaviour change communication.
南苏丹首当其冲遭受了多年的长期战乱，可能是撒哈拉以南非洲疟疾负担最重的国家。疟疾是该国发病和死亡的主要原因。这项具有全国代表性的调查旨在提供全国家庭层面疟疾指标的数据。
2009年，在南苏丹的一次疟疾指标调查（MIS）中，采用两阶段随机整群抽样法，从150个人口普查枚举区的2797户家庭中收集数据。该调查确定了弱势群体中的寄生虫感染率和贫血患病率，并评估了疟疾控制服务的覆盖范围、使用情况和可及性。标准化的减疟监测与评价参考小组（RBM-MERG）的MIS家庭问卷和妇女问卷根据当地情况进行了调整，用于收集数据，并使用描述性统计方法进行分析和总结。
本次调查结果显示，59.3%（95%置信区间：57.5 - 61.1）的家庭拥有至少一顶蚊帐。家庭中能够使用驱虫蚊帐的人口比例为49.7%（95%置信区间：48.2 - 51.2）。驱虫蚊帐的使用率较低；五岁以下儿童为25.3%（95%置信区间：23.9 - 26.7），孕妇为35.9%（95%置信区间：31.9 - 40.2）（比值比：1.66（1.36 - 2.01）；P = 0.175）。五岁以下儿童的感染率为24.5%（95%置信区间：23.0 - 26.1），孕妇为9.9%（95%置信区间：7.4 - 13.1）。约三分之二（64%）的五岁以下儿童和46%的孕妇贫血。前一年只有2%的家庭接受了室内滞留喷洒（IRS）。数据显示，58%的人报告说疟疾是由蚊子传播的，34%的人提到使用蚊帐可以预防疟疾，41%的人知道疟疾的正确治疗方法，52%的儿童在医疗机构接受了治疗。
观察到的高疟疾患病率可能是由于干预措施的覆盖范围和使用率较低以及知识水平较低所致。因此，应通过扩大覆盖范围和改善行为改变传播来提高疟疾控制工具的可及性和使用率。
