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坦桑尼亚东部莫罗戈罗农村地区潜在高疟疾流行区疟疾病例的回顾性分析

Retrospective Analysis of Malaria Cases in a Potentially High Endemic Area of Morogoro Rural District, Eastern Tanzania.

作者信息

Aikambe Joseph N, Mnyone Ladslaus L

机构信息

Department of Microbiology, Parasitology and Biotechnology, College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro, Tanzania.

Pest Management Centre, Sokoine University of Agriculture, Morogoro, Tanzania.

出版信息

Res Rep Trop Med. 2020 Jun 12;11:37-44. doi: 10.2147/RRTM.S254577. eCollection 2020.

Abstract

BACKGROUND

Malaria is increasingly characterized by appreciable fine-scale variability in ecology and topography, and it is likely that we are missing some salient foci with unprecedented malaria transmission intensity in different parts of Tanzania. Therefore, efforts aimed at identifying area-specific malaria situation and intervening are needed to preserve the realized health gains and achieve elimination. Mkuyuni and Kiroka, adjacent wards within Morogoro Rural District, are purported to form one of such foci.

PATIENTS AND METHODS

A retrospective study was conducted to determine six-year (2014-2019) malaria prevalence rates based on outpatients and laboratory registers obtained from two health facilities, one per ward, carrying out diagnosis of malaria either through microscopy or malaria rapid diagnostic test (mRDT). These data were checked for completeness before carrying out statistical analysis.

RESULTS

Overall, 35,386 (46.19%) out of 76,604 patients were positive for malaria. The average proportion of malaria cases was significantly higher in Mkuyuni (51.23%; n=19,438) than Kiroka (41.21%; n = 15,938) (P <0.001). Females were more affected than males (P <0.001);, and irrespective of the sex, most malaria cases were recorded in children <5 years of age (P <0.001) except at Mkuyuni. Malaria was recorded virtually all year round; however, the highest proportion of cases was recorded in April and July (P <0.001).

CONCLUSION

This study revealed high malaria endemicity in Mkuyuni and Kiroka, with prevalence rate as high as 60.98%, which is far higher than the overall national average prevalence of 9%. More studies are needed in these and other putatively high endemic foci in Tanzania in order to inform the future course of action in disease surveillance and control.

摘要

背景

疟疾在生态和地形方面日益呈现出明显的小尺度变异性,很可能在坦桑尼亚不同地区存在一些具有前所未有的疟疾传播强度的显著疫源地而未被我们发现。因此,需要努力识别特定地区的疟疾情况并进行干预,以保持已取得的健康成果并实现消除疟疾的目标。莫罗戈罗农村地区相邻的姆库尤尼和基罗卡两个行政区据称构成了这样的疫源地之一。

患者与方法

开展了一项回顾性研究,根据从两个卫生机构(每个行政区一个)获取的门诊和实验室登记册,确定六年(2014 - 2019年)的疟疾患病率,这两个卫生机构通过显微镜检查或疟疾快速诊断试验(mRDT)进行疟疾诊断。在进行统计分析之前,对这些数据的完整性进行了检查。

结果

总体而言,76,604名患者中有35,386名(46.19%)疟疾检测呈阳性。姆库尤尼的疟疾病例平均比例(51.23%;n = 19,438)显著高于基罗卡(41.21%;n = 15,938)(P < 0.001)。女性比男性受影响更严重(P < 0.001);并且无论性别如何,除姆库尤尼外,大多数疟疾病例记录在5岁以下儿童中(P < 0.001)。疟疾几乎全年都有记录;然而,病例比例最高的是在4月和7月(P < 0.001)。

结论

本研究揭示了姆库尤尼和基罗卡的疟疾高流行率,患病率高达60.98%,远高于全国总体平均患病率9%。为了为坦桑尼亚这些以及其他假定的高流行疫源地未来的疾病监测和控制行动提供依据,需要开展更多研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8980/7297450/02dda48570fb/RRTM-11-37-g0001.jpg

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