Searle Kelly M, Lubinda Jailos, Hamapumbu Harry, Shields Timothy M, Curriero Frank C, Smith David L, Thuma Philip E, Moss William J
Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Macha Research Trust, Macha, Choma District, Zambia.
R Soc Open Sci. 2017 May 3;4(5):170046. doi: 10.1098/rsos.170046. eCollection 2017 May.
In areas approaching malaria elimination, human mobility patterns are important in determining the proportion of malaria cases that are imported or the result of low-level, endemic transmission. A convenience sample of participants enrolled in a longitudinal cohort study in the catchment area of Macha Hospital in Choma District, Southern Province, Zambia, was selected to carry a GPS data logger for one month from October 2013 to August 2014. Density maps and activity space plots were created to evaluate seasonal movement patterns. Time spent outside the household compound during anopheline biting times, and time spent in malaria high- and low-risk areas, were calculated. There was evidence of seasonal movement patterns, with increased long-distance movement during the dry season. A median of 10.6% (interquartile range (IQR): 5.8-23.8) of time was spent away from the household, which decreased during anopheline biting times to 5.6% (IQR: 1.7-14.9). The per cent of time spent in malaria high-risk areas for participants residing in high-risk areas ranged from 83.2% to 100%, but ranged from only 0.0% to 36.7% for participants residing in low-risk areas. Interventions targeted at the household may be more effective because of restricted movement during the rainy season, with limited movement between high- and low-risk areas.
在接近疟疾消除的地区,人类流动模式对于确定输入性疟疾病例的比例或低水平地方性传播的结果至关重要。在赞比亚南部省乔马区马查医院集水区参与一项纵向队列研究的参与者中选取了一个便利样本,让他们在2013年10月至2014年8月期间携带GPS数据记录器一个月。绘制了密度图和活动空间图以评估季节性移动模式。计算了在按蚊叮咬时间期间在家庭院落外度过的时间,以及在疟疾高风险和低风险地区度过的时间。有证据表明存在季节性移动模式,旱季期间长途移动增加。有10.6%(四分位间距(IQR):5.8 - 23.8)的时间是在家庭外度过的,在按蚊叮咬时间期间这一比例降至5.6%(IQR:1.7 - 14.9)。居住在高风险地区的参与者在疟疾高风险地区度过的时间百分比在83.2%至100%之间,但居住在低风险地区的参与者这一比例仅在0.0%至36.7%之间。由于雨季期间行动受限,高风险和低风险地区之间的移动有限,针对家庭的干预措施可能更有效。