Grupo Malaria-Facultad de Medicina, Universidad de Antioquia, Carrera 53 No. 61-30, Lab 610, Medellín, Colombia.
Instituto de Investigaciones Médicas, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
Malar J. 2020 Apr 16;19(1):157. doi: 10.1186/s12936-020-03226-4.
The indigenous population is considered a highly susceptible group to malaria because individuals usually live in areas with high exposure to Anopheles and poverty, and have limited access to health services. There is a great diversity of indigenous communities in Colombia living in malaria-endemic areas; however, the burden of infection in these populations has not been studied extensively. This study aimed to determine the prevalence of Plasmodium infections in indigenous and non-indigenous communities in two malaria-endemic areas in Colombia.
A community-based cross-sectional survey was conducted in seven villages of Turbo and El Bagre municipalities; three of these villages were indigenous communities. Inhabitants of all ages willing to participate were included. Sociodemographic and clinical data were recorded as well as household information. The parasitological diagnosis was performed by microscopy and nested PCR. The prevalence of microscopy and submicroscopic infection was estimated. An adjusted GEE model was used to explore risk factors associated with the infection.
Among 713 participants, 60.7% were from indigenous communities. Plasmodium spp. was detected in 30 subjects (4.2%, CI 95% 2.9-5.9); from those, 29 were in the indigenous population, 47% of infections were afebrile, and most of them submicroscopic (10/14). Microscopic and submicroscopic prevalence was 2.5% (CI 95% 1.6-3.9) and 1.7% (CI 95% 0.9-2.9), respectively. In El Bagre, all infections occurred in indigenous participants (3.9%, CI 95% 2.2-7.1), and 81% were submicroscopic. By contrast, in Turbo, the highest prevalence occurred in indigenous people (11.5%; CI 95%: 7.3-17.5), but 88.8% were microscopic. Living in an indigenous population increased the prevalence of infection compared with a non-indigenous population (PR 19.4; CI 95% 2.3-166.7).
There is a high proportion of Plasmodium infection in indigenous communities. A substantial proportion of asymptomatic and submicroscopic carriers were detected. The identification of these infections, not only in indigenous but also in the non-indigenous population, as well as their associated factors, could help to implement specific malaria strategies for each context.
土著人群被认为是疟疾的高度易感人群，因为他们通常生活在疟蚊暴露度高和贫困的地区，并且获得卫生服务的机会有限。哥伦比亚有许多生活在疟疾流行地区的土著社区，但这些人群的感染负担尚未得到广泛研究。本研究旨在确定哥伦比亚两个疟疾流行地区的土著和非土著社区中疟原虫感染的流行率。
在特urbo 和埃尔巴格雷市的七个村庄进行了一项基于社区的横断面调查；其中三个村庄是土著社区。所有愿意参加的年龄在任何年龄段的居民都被纳入研究。记录社会人口学和临床数据以及家庭信息。寄生虫学诊断通过显微镜检查和巢式 PCR 进行。估计了显微镜和亚显微镜感染的流行率。使用调整后的 GEE 模型探索与感染相关的危险因素。
在 713 名参与者中，60.7%来自土著社区。在 30 名受试者（4.2%，95%CI 2.9-5.9）中检测到疟原虫属。其中 29 人来自土著人群，47%的感染为无热，其中大多数为亚显微镜感染（10/14）。显微镜和亚显微镜的流行率分别为 2.5%（95%CI 1.6-3.9）和 1.7%（95%CI 0.9-2.9）。在埃尔巴格雷，所有感染均发生在土著参与者中（3.9%，95%CI 2.2-7.1），且 81%为亚显微镜感染。相比之下，在特urbo，土著人群的感染率最高（11.5%；95%CI：7.3-17.5），但 88.8%为显微镜感染。与非土著人群相比，生活在土著人群中增加了感染的流行率（PR 19.4；95%CI 2.3-166.7）。
土著社区中存在很高比例的疟原虫感染。检测到大量无症状和亚显微镜携带者。不仅在土著人群，而且在非土著人群中识别这些感染及其相关因素，可以帮助为每个具体情况制定特定的疟疾防控策略。
