Inthavong Nouhak, Nonaka Daisuke, Kounnavong Sengchanh, Iwagami Moritoshi, Phommala Souraxay, Kobayashi Jun, Hongvanthong Bouasy, Pongvongsa Tiengkham, Brey Paul T, Kano Shigeyuki
Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, Uehara 207, Nishihara-cho, Okinawa, 903-0215 Japan.
SATREPS Project for Parasitic Diseases, Vientiane, Lao People's Democratic Republic.
Trop Med Health. 2017 Nov 7;45:36. doi: 10.1186/s41182-017-0077-2. eCollection 2017.
In the Lao PDR, the incidence of malaria greatly differs among villages even within a subdistrict, and the reasons for this difference are poorly understood. The objective of this study was to identify differences in villagers' behavior and the household environment between villages with high incidences and those with low incidences of malaria in a rural district of the Lao PDR.
A case-control study was conducted in Xepon district, Savannakhet province. Case villages were defined as those with a high incidence (> 10 cases per 1000 population per year), and control villages were those with a low incidence (0-10 cases per 1000 population per year). Data were collected from 178 households in the six case villages and six control villages between December 2016 and January 2017. The data collection consisted of an interview survey with the heads of households and an observational survey in and around the house. Logistic regression was used to assess the association between the case-control status and individual-level behavioral factors and household-level environmental factors adjusted for socio-demographic and economic factors.
Compared to the household members in the control villages, household members in the case villages were significantly more likely to work at night in the forest (adjusted odds ratio 1.95; 95% confidence interval 1.28 to 2.98) and more likely to sleep overnight in the forest (adjusted odds ratio 1.94; 95% confidence interval 1.13 to 3.33). Additionally, compared to the households in the control villages, households in the case villages were significantly more likely to have an open space on the house surface (adjusted odds ratio 3.64; 95% confidence interval 1.68 to 7.84).
There were significant differences in nighttime working and sleeping behaviors in the forest and the presence of an open space on the house surface in the case versus control villages. These differences can partly explain the difference in the incidences of malaria among the villages. The Lao National Malaria Control Program should recommend that villagers use personal protection when working and sleeping in the forest and to reduce any open space on the house surfaces.
在老挝人民民主共和国，即使在一个县区内，不同村庄的疟疾发病率也存在很大差异，而造成这种差异的原因尚不清楚。本研究的目的是确定老挝人民民主共和国一个农村地区疟疾高发村庄和低发村庄村民行为及家庭环境的差异。
在沙湾拿吉省色蓬县开展了一项病例对照研究。病例村定义为发病率高（每年每1000人口>10例）的村庄，对照村为发病率低（每年每1000人口0 - 10例）的村庄。2016年12月至2017年1月期间，从6个病例村和6个对照村的178户家庭收集了数据。数据收集包括对户主的访谈调查以及房屋内外的观察调查。采用逻辑回归分析来评估病例对照状态与个体层面行为因素和家庭层面环境因素之间的关联，并对社会人口学和经济因素进行了调整。
与对照村的家庭成员相比，病例村的家庭成员在夜间到森林劳作的可能性显著更高（调整比值比1.95；95%置信区间1.28至2.98），在森林过夜睡觉的可能性也显著更高（调整比值比1.94；95%置信区间1.13至3.33）。此外，与对照村的家庭相比，病例村的家庭房屋表面有开放空间的可能性显著更高（调整比值比3.64；95%置信区间1.68至7.84）。
病例村和对照村在夜间于森林劳作和睡觉的行为以及房屋表面是否有开放空间方面存在显著差异。这些差异可以部分解释不同村庄间疟疾发病率的差异。老挝国家疟疾控制项目应建议村民在森林劳作和睡觉时使用个人防护措施，并减少房屋表面的开放空间。
