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2017 年埃塞俄比亚北部 Laelay Adyabo 区疟疾疫情爆发的相关风险因素:病例对照研究设计。

Risk factors associated with malaria outbreak in Laelay Adyabo district northern Ethiopia, 2017: case-control study design.

机构信息

College of Health Sciences, Mekelle University, Mekelle, Ethiopia.

Tigray Health Research Institute, Mekelle, Ethiopia.

出版信息

BMC Public Health. 2019 May 2;19(1):484. doi: 10.1186/s12889-019-6798-x.

Abstract

BACKGROUND

Globally in 2015 about 214 million malaria cases and 438,000 deaths were reported with 75% were from Sub-Saharan Africa. Malaria transmission in Ethiopia is unstable, and outbreaks are considered public health emergencies. Understanding the trigger for outbreaks in low-transmission areas can help facilitate malaria elimination. On July 8th malaria outbreak was reported from Laelay Adyabo district. The objective was to investigate the magnitude and associated factors with malaria outbreak.

METHODS

We defined a case as confirmed malaria using microscopy or a rapid diagnostic test for Plasmodium parasites in a resident of Laelay-Adyabo District from July 9-28, 2017. We identified cases by reviewing health facility records and conducted a case-control study using randomly-selected cases from a line list, and two neighborhood controls per case. A pretested semi-structured questionnaire adapted from WHO malaria guidelines was used to collect data from case-patients and controls. We calculated crude (COR) and adjusted (AOR) odds ratios to identify factors associated with malaria.

RESULT

A total of 145 confirmed malaria cases (57.9% males) were identified with village attack rate (AR) of 12.1/1000. The AR was higher among males than females (14.1 verses 10.1/1000), children aged 5-14 years (12.9/1000), and in Zelazle Kebelle (13.6/1000 population). Wearing protective clothing (AOR = 0.27, 95% CI 0.11-0.66), having good knowledge of malaria transmission (AOR = 0.25, 95% CI 0.08-0.75), having waste collection material at home (AOR = 0.25 95% CI 0.11-0.61), availability of mosquito breeding sites around home (AOR = 9.08, 95% CI 3.6-22.93), and staying outdoor overnight (AOR = 3.7, 95% CI 1.44-9.56) were independently associated with malaria.

CONCLUSION

The overall attack rate for malaria during this outbreak was high affecting > 1% of the population. Wearing protective clothing at night, knowing about malaria transmission, having mosquito breeding sites around the home, staying outdoors overnight, and having waste collection material in their house were predictors of the infection. Laelay Adyabo district health office should provide health education on malaria transmission and prevention measures and how to clear mosquito breeding sites.

摘要

背景

全球范围内,2015 年报告了约 2.14 亿疟疾病例和 43.8 万人死亡,其中 75%来自撒哈拉以南非洲。埃塞俄比亚的疟疾传播不稳定,疫情爆发被视为公共卫生紧急事件。了解低传播地区疫情爆发的触发因素有助于促进疟疾消除。2017 年 7 月 8 日,Laelay Adyabo 区报告了疟疾疫情。本研究旨在调查此次疫情的规模及其与疟疾爆发相关的因素。

方法

我们将 2017 年 7 月 9 日至 28 日期间,Laelay-Adyabo 区居住的经显微镜检查或快速诊断试验确诊疟疾病例定义为病例。我们通过查阅医疗机构记录和对来自病例名单的随机选择病例,以及每个病例的两名邻居对照进行病例对照研究来识别病例。我们使用来自世界卫生组织疟疾指南的预测试半结构化问卷收集病例患者和对照的数据。我们计算了粗(COR)和调整(AOR)比值,以确定与疟疾相关的因素。

结果

共发现 145 例确诊疟疾病例(57.9%为男性),村庄发病率(AR)为 12.1/1000。男性的 AR 高于女性(14.1 比 10.1/1000),5-14 岁儿童(12.9/1000)和 Zelazle Kebelle(13.6/1000 人口)。穿着防护服(AOR=0.27,95%CI 0.11-0.66)、对疟疾传播有良好的认识(AOR=0.25,95%CI 0.08-0.75)、家中有垃圾收集材料(AOR=0.25,95%CI 0.11-0.61)、家中周围有蚊子滋生地(AOR=9.08,95%CI 3.6-22.93)和夜间在户外过夜(AOR=3.7,95%CI 1.44-9.56)与疟疾独立相关。

结论

此次疫情期间,疟疾的总发病率很高,影响了超过 1%的人口。夜间穿着防护服、了解疟疾传播知识、家中周围有蚊子滋生地、夜间在户外过夜以及家中有垃圾收集材料是感染的预测因素。Laelay Adyabo 区卫生办公室应提供疟疾传播和预防措施的健康教育,以及如何清除蚊子滋生地。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49e0/6498533/d7eda68c3941/12889_2019_6798_Fig1_HTML.jpg

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