Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Building 2, Room 329, Boston, MA, 02115, USA.
Department of Organismic and Evolutionary Biology, Harvard University, Cambridge, USA.
Malar J. 2020 Sep 29;19(1):348. doi: 10.1186/s12936-020-03423-1.
Deforestation and land use change is widespread in Madagascar, altering local ecosystems and creating opportunities for disease vectors, such as the Anopheles mosquito, to proliferate and more easily reach vulnerable, rural populations. Knowledge of risk factors associated with malaria infections is growing globally, but these associations remain understudied across Madagascar's diverse ecosystems experiencing rapid environmental change. This study aims to uncover socioeconomic, demographic, and ecological risk factors for malaria infection across regions through analysis of a large, cross-sectional dataset.
The objectives were to assess (1) the ecological correlates of malaria vector breeding through larval surveys, and (2) the socioeconomic, demographic, and ecological risk factors for malaria infection in four ecologically distinct regions of rural Madagascar. Risk factors were determined using multilevel models for the four regions included in the study.
The presence of aquatic agriculture (both within and surrounding communities) is the strongest predictive factor of habitats containing Anopheles larvae across all regions. Ecological and socioeconomic risk factors for malaria infection vary dramatically across study regions and range in their complexity.
Risk factors for malaria transmission differ dramatically across regions of Madagascar. These results may help stratifying current malaria control efforts in Madagascar beyond the scope of existing interventions.
马达加斯加的森林砍伐和土地利用变化广泛存在，改变了当地的生态系统，为疾病媒介（如疟蚊）的繁殖和更容易接触到脆弱的农村人口创造了机会。全球范围内，与疟疾感染相关的风险因素的知识正在不断增加，但在经历快速环境变化的马达加斯加多样化生态系统中，这些关联仍研究不足。本研究旨在通过分析大型横断面数据集，揭示疟疾感染在不同地区的社会经济、人口和生态风险因素。
本研究的目的是评估（1）通过幼虫调查来评估疟疾媒介滋生的生态相关性，以及（2）在马达加斯加农村的四个生态区中，疟疾感染的社会经济、人口和生态风险因素。通过对研究中包含的四个地区的多水平模型来确定风险因素。
水生农业（无论是在社区内还是周围）的存在是所有地区含有疟蚊幼虫的栖息地的最强预测因素。疟疾感染的生态和社会经济风险因素在研究地区之间存在显著差异，且其复杂性也不同。
疟疾传播的风险因素在马达加斯加的不同地区有很大的差异。这些结果可能有助于在现有的干预措施之外，对马达加斯加的疟疾控制工作进行分层。
