坦桑尼亚南部实施季节性疟疾化学预防地区五岁以下儿童疟疾感染和贫血状况。
Malaria infection and anemia status in under-five children from Southern Tanzania where seasonal malaria chemoprevention is being implemented.
机构信息
Department of Microbiology, Immunology and Parasitology, Hubert Kairuki Memorial University, Dar es Salaam, Tanzania.
Tanga Research Centre, National Institute for Medical Research, Tanga, Tanzania.
出版信息
PLoS One. 2021 Dec 2;16(12):e0260785. doi: 10.1371/journal.pone.0260785. eCollection 2021.
BACKGROUND
Malaria and anemia remain major public health challenges in Tanzania. Household socioeconomic factors are known to influence these conditions. However, it is not clear how these factors influence malaria transmission and anemia in Masasi and Nanyumbu Districts. This study presents findings on malaria and anemia situation in under-five children and its influencing socioeconomic factors in Masasi and Nanyumbu Districts, surveyed as part of an ongoing seasonal malaria chemoprevention operational study.
METHODS
A community-based cross-sectional survey was conducted between August and September 2020. Finger-prick blood samples collected from children aged 3-59 months were used to test for malaria infection using malaria rapid diagnostic test (mRDT), thick smears for determination of asexual and sexual parasitemia, and thin smear for parasite speciation. Hemoglobin concentration was measured using a HemoCue spectrophotometer. A structured questionnaire was used to collect household socioeconomic information from parents/caregivers of screened children. The prevalence of malaria was the primary outcome. Chi-square tests, t-tests, and logistic regression models were used appropriately.
RESULTS
Overall mRDT-based malaria prevalence was 15.9% (373/2340), and was significantly higher in Nanyumbu (23.7% (167/705) than Masasi District (12.6% (206/1635), p<0.001. Location (Nanyumbu), no formal education, household number of people, household number of under-fives, not having a bed net, thatched roof, open/partially open eave, sand/soil floor, and low socioeconomic status were major risks for malaria infection. Some 53.9% (1196/2218) children had anemia, and the majority were in Nanyumbu (63.5% (458/705), p<0.001. Location (Nanyumbu), mRDT positive, not owning a bed net, not sleeping under bed net, open/partially open eave, thatched window, sex of the child, and age of the child were major risk factors for anemia.
CONCLUSION
Prevalence of malaria and anemia was high and was strongly associated with household socioeconomic factors. Improving household socioeconomic status is expected to reduce the prevalence of the conditions in the area.
背景
疟疾和贫血仍然是坦桑尼亚的主要公共卫生挑战。家庭社会经济因素已知会影响这些情况。然而，目前尚不清楚这些因素如何影响马萨西和楠布乌地区的疟疾传播和贫血。本研究介绍了马萨西和楠布乌地区五岁以下儿童疟疾和贫血情况及其影响因素的调查结果，该研究是正在进行的季节性疟疾化学预防运营研究的一部分。
方法
2020 年 8 月至 9 月进行了一项基于社区的横断面调查。从 3-59 个月大的儿童采集指血样本，使用疟疾快速诊断检测（mRDT）检测疟疾感染，用厚涂片确定无性和有性寄生虫血症，用薄涂片确定寄生虫种型。使用 HemoCue 分光光度计测量血红蛋白浓度。使用结构化问卷从筛查儿童的父母/照顾者收集家庭社会经济信息。疟疾的患病率是主要结局。适当使用卡方检验、t 检验和逻辑回归模型。
结果
基于 mRDT 的总体疟疾患病率为 15.9%（373/2340），楠布乌（23.7%（167/705））显著高于马萨西区（12.6%（206/1635），p<0.001）。地点（楠布乌）、未接受正规教育、家庭人口数、家庭五岁以下儿童人数、没有蚊帐、茅草屋顶、敞开/部分敞开屋檐、沙/土地板和低社会经济地位是疟疾感染的主要危险因素。约 53.9%（1196/2218）的儿童贫血，其中大部分在楠布乌（63.5%（458/705），p<0.001）。地点（楠布乌）、mRDT 阳性、没有蚊帐、没有在蚊帐下睡觉、敞开/部分敞开屋檐、茅草窗户、儿童性别和儿童年龄是贫血的主要危险因素。
结论
疟疾和贫血的患病率很高，与家庭社会经济因素密切相关。改善家庭社会经济状况有望降低该地区这些疾病的患病率。
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