Sissoko Mahamadou S, van den Hoogen Lotus L, Samake Yacouba, Tapily Amadou, Diarra Adama Z, Coulibaly Maimouna, Bouare Madama, Gaudart Jean, Knight Philip, Sauerwein Robert W, Takken Willem, Bousema Teun, Doumbo Ogobara K
Department of Epidemiology of Parasitic Disease, Faculty of Medicine and Dentistry, Malaria Research and Training Center, University of Sciences, Techniques and Technologies of Bamako, Mali; Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, London, United Kingdom; Aix-Marseille University, Marseille, France; ConsultingWhere, Redbourn, St. Albans, United Kingdom; Laboratory of Entomology, Wageningen University and Research Center, Wageningen, The Netherlands.
Department of Epidemiology of Parasitic Disease, Faculty of Medicine and Dentistry, Malaria Research and Training Center, University of Sciences, Techniques and Technologies of Bamako, Mali; Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, London, United Kingdom; Aix-Marseille University, Marseille, France; ConsultingWhere, Redbourn, St. Albans, United Kingdom; Laboratory of Entomology, Wageningen University and Research Center, Wageningen, The Netherlands
Am J Trop Med Hyg. 2015 Oct;93(4):790-7. doi: 10.4269/ajtmh.14-0765. Epub 2015 Aug 31.
Heterogeneity in malaria exposure is most readily recognized in areas with low-transmission patterns. By comparison, little research has been done on spatial patterns in malaria exposure in high-endemic settings. We determined the spatial clustering of clinical malaria incidence, asymptomatic parasite carriage, and Anopheles density in two villages in Mali exposed to low- and mesoendemic-malaria transmission. In the two study areas that were < 1 km(2) in size, we observed evidence for spatial clustering of Anopheles densities or malaria parasite carriage during the dry season. Anopheles density and malaria prevalence appeared associated in some of our detected hotspots. However, many households with high parasite prevalence or high Anopheles densities were located outside the identified hotspots. Our findings indicate that within small villages exposed to low- or mesoendemic-malaria transmission, spatial patterns in mosquito densities and parasite carriage are best detected in the dry season. Considering the high prevalence of parasite carriage outside detected hotspots, the suitability of the area for targeting control efforts to households or areas of more intense malaria transmission may be limited.
疟疾暴露的异质性在低传播模式地区最容易被识别。相比之下，关于高流行地区疟疾暴露的空间模式研究较少。我们确定了马里两个暴露于低和中流行疟疾传播的村庄中临床疟疾发病率、无症状寄生虫携带率和按蚊密度的空间聚集情况。在两个面积小于1平方公里的研究区域，我们观察到旱季按蚊密度或疟原虫携带存在空间聚集的证据。在我们检测到的一些热点地区，按蚊密度和疟疾流行率似乎相关。然而，许多寄生虫患病率高或按蚊密度高的家庭位于已确定的热点地区之外。我们的研究结果表明，在暴露于低或中流行疟疾传播的小村庄内，旱季最容易检测到蚊子密度和寄生虫携带的空间模式。考虑到在检测到的热点地区之外寄生虫携带率很高，将控制措施针对性地应用于疟疾传播更严重的家庭或地区的适用性可能有限。
