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儿童疟疾寄生虫血症、贫血和营养不良在沿喀麦隆山脉不同海拔居住的 15 岁以下儿童中的流行情况、严重程度和危险因素。

Malaria parasitaemia, anaemia and malnutrition in children less than 15 years residing in different altitudes along the slope of Mount Cameroon: prevalence, intensity and risk factors.

机构信息

Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon.

Clinical Diagnostic Laboratory, University of Buea, Buea, Cameroon.

出版信息

Malar J. 2018 Sep 24;17(1):336. doi: 10.1186/s12936-018-2492-1.

Abstract

BACKGROUND

Malaria, anaemia and malnutrition are frequently co-existing diseases that cause significant morbidity and mortality particularly among children. This study measured the prevalence, intensity and evaluated risk factors for malaria parasitaemia, anaemia and malnutrition among children living at low versus high altitude settings in the Mount Cameroon area.

METHODS

A cross-sectional community based survey involving 828 children aged 6 months to 14 years was conducted between July and November 2017. Malaria parasitaemia was confirmed by light microscopy, haemoglobin concentration was measured using an auto haematology analyser, nutritional status was determined from the anthropometric measurements collected, and socioeconomic status related variables by the use of questionnaire. Anaemia and malnutrition were defined according to World Health Organization standards. Associations between predictor variables and primary outcomes were assessed using logistic regression analysis.

RESULTS

Malaria parasite and anaemia were prevalent in 41.7% and 56.2% of the children, respectively while, malnutrition prevalence was 34.8% with wasting, underweight and stunting occurring in 25.7%, 19.9% and 23.7% of them respectively. Overall malaria parasite geometric mean density was 413/µL of blood (range 100-27,060). The odds of having malaria parasitaemia was highest in children 5-9 years of age [odd ratio (OR) = 1.69, P = 0.006], living in lowland (OR = 1.48, P = 0.008) as well as those whose domestic water was collected from an open source (streams/springs) (OR = 1.81, P = 0.005) than their counterparts. Being < 5 years (OR = 3.15, P = < 0.001) or 5-9 years (OR = 2.20, P < 0.001) of age, having malaria parasite (OR = 2.07, P = < 0.001) and fever in the past 2 days (OR = 1.52, P < 0.04) were identified as significant risk factors of anaemia while the age group < 5 years was the only significant risk (OR = 3.09, P = < 0.001) associated with malnutrition.

CONCLUSION

While age specific attention should be given in the control of malaria (5-9 years), anaemia (< 10 years) and malnutrition (< 5 years), the existing malaria control programmes should be revised to integrate anaemia and malnutrition control strategies so as to improve upon the health of the children.

摘要

背景

疟疾、贫血和营养不良经常同时存在,这些疾病会导致发病率和死亡率显著上升,尤其是在儿童中。本研究旨在测量喀麦隆山地区低海拔和高海拔地区儿童中疟疾寄生虫血症、贫血和营养不良的流行率、强度,并评估其相关危险因素。

方法

2017 年 7 月至 11 月期间,进行了一项以社区为基础的横断面研究,共纳入 828 名年龄在 6 个月至 14 岁之间的儿童。通过显微镜检查确认疟疾寄生虫血症,使用自动血液学分析仪测量血红蛋白浓度,根据收集的人体测量数据确定营养状况,使用问卷确定与社会经济状况相关的变量。贫血和营养不良按照世界卫生组织的标准定义。使用逻辑回归分析评估预测变量与主要结局之间的关系。

结果

疟疾寄生虫和贫血分别在 41.7%和 56.2%的儿童中流行,而营养不良的流行率为 34.8%,其中消瘦、体重不足和发育迟缓分别占 25.7%、19.9%和 23.7%。总体而言,疟疾寄生虫的几何平均密度为 413/µL 血液(范围 100-27,060)。5-9 岁的儿童患疟疾寄生虫血症的几率最高(优势比[OR] = 1.69,P = 0.006),生活在低海拔地区(OR = 1.48,P = 0.008)以及家庭用水来自开放水源(溪流/泉水)(OR = 1.81,P = 0.005)的儿童比同龄人更容易患病。5 岁以下(OR = 3.15,P < 0.001)或 5-9 岁(OR = 2.20,P < 0.001)的儿童、患有疟疾寄生虫(OR = 2.07,P < 0.001)和过去 2 天发烧(OR = 1.52,P < 0.04)是贫血的显著危险因素,而 5 岁以下年龄组是营养不良的唯一显著危险因素(OR = 3.09,P = 0.001)。

结论

在控制疟疾(5-9 岁)、贫血(<10 岁)和营养不良(<5 岁)时,应根据年龄给予特别关注,同时应修订现有的疟疾控制计划,纳入贫血和营养不良控制策略,以提高儿童的健康水平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b10/6154899/8f20c8c53aaf/12936_2018_2492_Fig1_HTML.jpg

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