Population and Health Research Institute, Kinshasa, Democratic Republic of Congo.
Department of Population and Development Study, University of Kinshasa, Kinshasa, Democratic Republic of Congo.
PLoS One. 2021 May 6;16(5):e0250550. doi: 10.1371/journal.pone.0250550. eCollection 2021.
In 2018, Malaria accounted for 38% of the overall morbidity and 36% of the overall mortality in the Democratic Republic of Congo (DRC). This study aimed to identify malaria socioeconomic predictors among children aged 6-59 months in DRC and to describe a socioeconomic profile of the most-at-risk children aged 6-59 months for malaria infection.
This study used data from the 2013 DRC Demographic and Health Survey. The sample included 8,547 children aged 6-59 months who were tested for malaria by microscopy. Malaria infection status, the dependent variable, is a dummy variable characterized as a positive or negative test. The independent variables were child's sex, age, and living arrangement; mother's education; household's socioeconomic variables; province of residence; and type of place of residence. Statistical analyses used the chi-square automatic interaction detector (CHAID) model and logistic regression.
Of the 8,547 children included in the sample, 25% had malaria infection. Four variables-child's age, mother's education, province, and wealth index-were statistically associated with the prevalence of malaria infection in bivariate analysis and multivariate analysis (CHAID and logistic regression). The prevalence of malaria infection increases with child's age and decreases significantly with mother's education and the household wealth index. These findings suggest that the prevalence of malaria infection is driven by interactions among environmental factors, socioeconomic characteristics, and probably differences in the implementation of malaria programs across the country. The effect of mother's education on malaria infection was only significant among under-five children living in Ituri, Kasaï-Central, Haut-Uele, Lomami, Nord-Ubangi, and Maniema provinces, and the effect of wealth index was significant in Mai-Ndombe, Tshopo, and Haut-Katanga provinces.
Findings from this study could be used for targeting malaria interventions in DRC. Although malaria infection is common across the country, the prevalence of children at high risk for malaria infection varies by province and other background characteristics, including age, mother's education, wealth index, and place of residence. In light of these findings, designing provincial and multisectoral interventions could be an effective strategy to achieve zero malaria infection in DRC.
2018 年，疟疾在刚果民主共和国（DRC）的总发病率中占 38%，总死亡率中占 36%。本研究旨在确定 DRC 6-59 个月儿童疟疾的社会经济预测因素，并描述 6-59 个月儿童疟疾感染的最危险的社会经济特征。
本研究使用了 2013 年 DRC 人口与健康调查的数据。样本包括 8547 名 6-59 个月的儿童，他们通过显微镜检查检测疟疾感染情况。疟疾感染状况是一个二分类变量，分为阳性或阴性检测。自变量包括儿童的性别、年龄和居住安排；母亲的教育程度；家庭的社会经济变量；居住省份；以及居住地点的类型。统计分析使用了卡方自动交互检测（CHAID）模型和逻辑回归。
在纳入样本的 8547 名儿童中，25%患有疟疾感染。在单变量分析和多变量分析（CHAID 和逻辑回归）中，有四个变量与疟疾感染的流行情况有统计学关联：儿童年龄、母亲教育程度、省份和财富指数。儿童年龄越大，疟疾感染的流行率越高，而母亲的教育程度和家庭财富指数越低，疟疾感染的流行率越低。这些发现表明，疟疾感染的流行情况是由环境因素、社会经济特征之间的相互作用驱动的，而且可能是由于全国范围内疟疾规划的实施存在差异。母亲教育对疟疾感染的影响仅在伊图里、开赛-中、上韦莱、洛马米、北乌班吉和马涅马等省的 5 岁以下儿童中显著，而财富指数的影响在马伊恩东贝、下刚果和上开赛等省显著。
本研究的结果可用于在 DRC 开展疟疾干预措施。尽管疟疾在全国范围内普遍存在，但儿童感染疟疾的风险因省份和其他背景特征而有所不同，包括年龄、母亲的教育程度、财富指数和居住地点。鉴于这些发现，制定省级和多部门干预措施可能是实现 DRC 零疟疾感染的有效策略。
