Suleman M
Zoology Department, University of Peshawar, Pakistan.
Trans R Soc Trop Med Hyg. 1988;82(1):44-7. doi: 10.1016/0035-9203(88)90257-x.
Prevalence of malaria in Afghan refugees in Pakistan is higher than in the local population. Malaria control officials in Pakistan hypothesized that Afghan refugees have brought a heavy load of malaria infections with them from Afghanistan, causing a serious setback to the malaria control programme in Pakistan. The purpose of this study was to test this hypothesis, because it is important regarding the selection of appropriate strategy for malaria control. The proposed hypothesis is rejected because of the following evidence against it: (i) a comparison of age-specific parasite rates of malaria in Afghan refugees and a nearby local population at Karachi indicated that Afghan refugees were susceptible to malaria even in later age-groups, while infections in the local population were limited to younger age-groups; (ii) a comparison of epidemiological trends of malaria in Afghan refugees and the local population in the North-West Frontier Province from 1979 to 1986 demonstrated that the rate of increase in the prevalence of malaria over the years was much higher in Afghan refugees than in the local population, a manifestation of low herd immunity in Afghan refugees. The most plausible alternate hypothesis is that Afghan refugees, being more susceptible, were at high risk of malaria infection in Pakistan rather than that they brought a high infection load with them from Afghanistan. Therefore, malaria control in Afghan refugee camps in Pakistan should be primarily based on preventive, rather than curative, measures.
在巴基斯坦的阿富汗难民中，疟疾的流行率高于当地人口。巴基斯坦的疟疾控制官员推测，阿富汗难民从阿富汗带来了大量疟疾感染，给巴基斯坦的疟疾控制计划造成了严重挫折。本研究的目的是检验这一假设，因为这对于选择合适的疟疾控制策略很重要。由于以下反对证据，所提出的假设被否决：（i）对阿富汗难民和卡拉奇附近当地人口按年龄划分的疟疾寄生虫率进行比较表明，阿富汗难民即使在较高年龄组也易感染疟疾，而当地人口的感染仅限于较年轻年龄组；（ii）对1979年至1986年阿富汗难民和西北边境省当地人口的疟疾流行趋势进行比较表明，多年来阿富汗难民疟疾流行率的增长速度远高于当地人口，这表明阿富汗难民群体免疫力较低。最合理的替代假设是，阿富汗难民更易感染，在巴基斯坦感染疟疾的风险很高，而不是他们从阿富汗带来了高感染负荷。因此，巴基斯坦阿富汗难民营的疟疾控制应主要基于预防措施而非治疗措施。
