Roberts Danielle, Matthews Glenda
School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Westville, Private Bag X 54001, 4000, Durban, South Africa.
Malar J. 2016 Apr 27;15:246. doi: 10.1186/s12936-016-1290-x.
Malaria is the leading cause of morbidity in Uganda with 90-95 % of the population at risk and it contributing to approximately 13 % of under-five mortality. The aim of this study was to investigate the relationship between the malaria status of children under the age of 5 years old in Uganda and selected socio-economic, demographic and environmental factors, as well as to identify significant risk factors associated with malaria.
This study made use of data collected from the 2014 Malaria Indicator Survey conducted in Uganda. Two test procedures for malaria in children under the age of 5 years old were carried out. Due to the complex survey design, a generalized linear mixed model was used to test for associations between several independent variables and the response variable, which was whether a child tested positive or negative for malaria according to the microscopy test.
The sample in this study was made up of 4939 children. Of those children, 974 tested positive for malaria, resulting in an observed malaria prevalence of 19.7 %. The socio-economic factors closely related to the risk of malaria were main floor material, main wall material and availability of electricity in the household. The event of indoor residual spraying (IRS) significantly reduced a child's risk of malaria. An older child was associated with a higher risk of malaria, however their risk decreased with an increase in cluster altitude and an increase in their caregiver's education level.
Although there has been a significant increase in the use of mosquito nets since the previous Malaria Indicator Survey done in 2009, particularly in the use of insecticide-treated nets (ITNs) and long-lasting insecticidal nets (LLINs), these control measures alone may not be sufficient. IRS will be a key strategy in reaching the malaria goals set by the government of Uganda. Supplementing these control measures with education of appropriate and consistent use of ITNs and LLINs, as well as education of practicing safe living habits, such as reducing outdoor activities during peak biting hours of a mosquito, can go a long way in aiding the reduction of the burden of malaria in Uganda.
疟疾是乌干达发病的主要原因,90 - 95%的人口面临风险,且它导致了约13%的五岁以下儿童死亡。本研究的目的是调查乌干达5岁以下儿童的疟疾状况与选定的社会经济、人口和环境因素之间的关系,并确定与疟疾相关的重要风险因素。
本研究利用了乌干达2014年疟疾指标调查收集的数据。对5岁以下儿童进行了两种疟疾检测程序。由于调查设计复杂,使用广义线性混合模型来检验几个自变量与因变量之间的关联,因变量是根据显微镜检测儿童疟疾检测呈阳性或阴性。
本研究的样本由4939名儿童组成。其中,974名儿童疟疾检测呈阳性,观察到的疟疾患病率为19.7%。与疟疾风险密切相关的社会经济因素是房屋的主要地面材料、主要墙壁材料和家庭供电情况。室内滞留喷洒(IRS)事件显著降低了儿童患疟疾的风险。年龄较大的儿童患疟疾的风险较高,然而随着聚居地海拔的升高和其照顾者教育水平的提高,他们的风险会降低。
自2009年上次疟疾指标调查以来,蚊帐的使用显著增加,特别是杀虫剂处理蚊帐(ITNs)和长效杀虫剂蚊帐(LLINs)的使用,但仅这些控制措施可能还不够。室内滞留喷洒将是实现乌干达政府设定的疟疾目标的关键战略。通过对正确和持续使用杀虫剂处理蚊帐和长效杀虫剂蚊帐进行教育,以及对养成安全生活习惯(如在蚊子叮咬高峰期减少户外活动)进行教育来补充这些控制措施,对于减轻乌干达的疟疾负担大有帮助。