Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.
Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
Malar J. 2021 Oct 2;20(1):389. doi: 10.1186/s12936-021-03919-4.
Malaria remains a major public health concern in the Democratic Republic of Congo (DRC), and school-age children are relatively neglected in malaria prevalence surveys and may constitute a significant reservoir of transmission. This study aimed to understand the burden of malaria infections in school-age children in Kinshasa/DRC.
A total of 634 (427 asymptomatic and 207 symptomatic) blood samples collected from school-age children aged 6 to 14 years were analysed by microscopy, RDT and Nested-PCR.
The overall prevalence of Plasmodium spp. by microscopy, RDT and PCR was 33%, 42% and 62% among asymptomatic children and 59%, 64% and 95% in symptomatic children, respectively. The prevalence of Plasmodium falciparum, Plasmodium malariae and Plasmodium ovale spp. by PCR was 58%, 20% and 11% among asymptomatic and 93%, 13% and 16% in symptomatic children, respectively. Among P. ovale spp., P. ovale curtisi, P. ovale wallikeri and mixed P. ovale curtisi + P. ovale wallikeri accounted for 75%, 24% and 1% of infections, respectively. All Plasmodium species infections were significantly more prevalent in the rural area compared to the urban area in asymptomatic infections (p < 0.001). Living in a rural as opposed to an urban area was associated with a five-fold greater risk of asymptomatic malaria parasite carriage (p < 0.001). Amongst asymptomatic malaria parasite carriers, 43% and 16% of children harboured mixed Plasmodium with P. falciparum infections in the rural and the urban areas, respectively, whereas in symptomatic malaria infections, it was 22% and 26%, respectively. Few children carried single infections of P. malariae (2.2%) and P. ovale spp. (1.9%).
School-age children are at significant risk from both asymptomatic and symptomatic malaria infections. Continuous systematic screening and treatment of school-age children in high-transmission settings is needed.
疟疾仍然是刚果民主共和国（DRC）的一个主要公共卫生问题，学龄儿童在疟疾患病率调查中相对被忽视，可能构成重要的传播源。本研究旨在了解金沙萨/DRC 学龄儿童的疟疾感染负担。
共分析了 634 份（427 份无症状和 207 份有症状）来自 6 至 14 岁学龄儿童的血液样本，采用显微镜检查、RDT 和巢式 PCR 进行分析。
显微镜检查、RDT 和 PCR 检测的总疟原虫感染率在无症状儿童中分别为 33%、42%和 62%，在有症状儿童中分别为 59%、64%和 95%。PCR 检测的间日疟原虫、恶性疟原虫和卵形疟原虫感染率在无症状儿童中分别为 58%、20%和 11%，在有症状儿童中分别为 93%、13%和 16%。卵形疟原虫感染中，卵形疟原虫 curtisi、卵形疟原虫 wallikeri 和混合卵形疟原虫 curtisi+卵形疟原虫 wallikeri 分别占 75%、24%和 1%。所有疟原虫感染在无症状感染中均显著更常见于农村地区，而不是城市地区（p<0.001）。与居住在城市地区相比，居住在农村地区与无症状疟原虫携带的风险增加五倍相关（p<0.001）。在无症状疟原虫携带者中，农村地区和城市地区分别有 43%和 16%的儿童携带恶性疟原虫混合感染，而在有症状疟疾感染中，这一比例分别为 22%和 26%。少数儿童携带单一感染的间日疟原虫（2.2%）和卵形疟原虫（1.9%）。
学龄儿童面临着严重的无症状和有症状疟疾感染风险。在高传播地区，需要持续系统地筛查和治疗学龄儿童。
