空间分析评估印度尼西亚北苏门答腊的疟疾风险。

Spatial analysis to evaluate risk of malaria in Northern Sumatera, Indonesia.

机构信息

Department of Electrical Engineering, Universitas Sumatera Utara, Medan, 20155, Indonesia.

Department of Child Health, Medical Faculty, Universitas Sumatera Utara, Medan, 20155, Indonesia.

出版信息

Malar J. 2022 Aug 20;21(1):241. doi: 10.1186/s12936-022-04262-y.

DOI:10.1186/s12936-022-04262-y

PMID:35987665

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9392258/

Abstract

BACKGROUND

As Indonesia aims for malaria elimination by 2030, provisional malaria epidemiology and risk factors evaluation are important in pursue of this national goal. Therefore, this study aimed to understand the risk factor of malaria in Northern Sumatera.

METHODS

Malaria cases from 2019 to 2020 were obtained from the Indonesian Ministry of Health Electronic Database. Climatic variables were provided by the Center for Meteorology and Geophysics Medan branch office. Multivariable logistic regression was undertaken to understand the risk factors of imported malaria. A zero-inflated Poisson multivariable regression model was used to study the climatic drivers of indigenous malaria.

RESULTS

A total of 2208 (indigenous: 76.0% [1679] and imported: 17.8% [392]) were reported during the study period. Risk factors of imported malaria were: ages 19-30 (adjusted odds ratio [AOR] = 3.31; 95% confidence interval [CI] 1.67, 2.56), 31-45 (AOR = 5.69; 95% CI 2.65, 12.20), and > 45 years (AOR = 5.11; 95% CI 2.41, 10.84). Military personnel and forest workers and miners were 1,154 times (AOR = 197.03; 95% CI 145.93, 9,131.56) and 44 times (AOR = 44.16; 95% CI 4.08, 477,93) more likely to be imported cases as compared to those working as employees and traders. Indigenous Plasmodium falciparum increased by 12.1% (95% CrI 5.1%, 20.1%) for 1% increase in relative humidity and by 21.0% (95% CrI 9.0%, 36.2%) for 1 °C increase in maximum temperature. Plasmodium vivax decreased by 0.8% (95% CrI 0.2%, 1.3%) and 16.7% (95% CrI 13.7%, 19.9%) for one meter and 1 °C increase of altitude and minimum temperature. Indigenous hotspot was reported by Kota Tanjung Balai city and Asahan regency, respectively. Imported malaria hotspots were reported in Batu Bara, Kota Tebing Tinggi, Serdang Bedagai and Simalungun.

CONCLUSION

Both indigenous and imported malaria is limited to a few regencies and cities in Northern Sumatera. The control measures should focus on these risk factors to achieve elimination in Indonesia.

摘要

背景

随着印度尼西亚力争在 2030 年消除疟疾，临时疟疾流行病学和危险因素评估对于实现这一国家目标非常重要。因此，本研究旨在了解北苏门答腊的疟疾危险因素。

方法

从印度尼西亚卫生部电子数据库中获取 2019 年至 2020 年的疟疾病例。气候变量由棉兰气象和地球物理中心分局提供。采用多变量逻辑回归了解输入性疟疾的危险因素。采用零膨胀泊松多变量回归模型研究本地疟疾的气候驱动因素。

结果

研究期间共报告了 2208 例（本地：76.0%[1679 例]和输入性：17.8%[392 例]）。输入性疟疾的危险因素包括：年龄 19-30 岁（调整后的优势比[OR]为 3.31；95%置信区间[CI]为 1.67，2.56）、31-45 岁（OR 为 5.69；95%CI 为 2.65，12.20）和>45 岁（OR 为 5.11；95%CI 为 2.41，10.84）。军人、林业工人和矿工的输入性疟疾病例是雇员和贸易商的 1154 倍（OR 为 197.03；95%CI 为 145.93，9131.56）和 44 倍（OR 为 44.16；95%CI 为 4.08，477.93）。相对湿度每增加 1%，本地间日疟原虫增加 12.1%（95%CrI 为 5.1%，20.1%），最高温度每增加 1°C，间日疟原虫增加 21.0%（95%CrI 为 9.0%，36.2%）。恶性疟原虫减少 0.8%（95%CrI 为 0.2%，1.3%）和 16.7%（95%CrI 为 13.7%，19.9%），海拔和最低温度每增加 1 米和 1°C。多巴塔朗巴莱市和亚沙汉县分别报告了本地疟疾病例热点。巴图巴雷、棉兰高地、瑟当巴戈和西马伦古的输入性疟疾病例热点报告。