Water and Public Health Stream, Ethiopian Institute of Water Resources, Addis Ababa University, Addis Ababa, Ethiopia.
Tuberculosis/HIV Research Directorate, Ethiopian Public Health Institute, P.O. Box 1242, Addis Ababa, Ethiopia.
Infect Dis Poverty. 2022 Sep 5;11(1):94. doi: 10.1186/s40249-022-01018-3.
A significant decline in malaria burden was documented in previously high burden African countries. Even though the global decline in malaria burden is significant, about 95% of it was typically found in 29 African countries and the decline was affected by COVID-19 in 2020. The considerable reduction in malaria incidence was noted due to effective prevention and treatment efforts, and rapid changes in living conditions. The relationship between the occurrence of asymptomatic malaria infection and household living conditions is well unstudied. This study aimed to determine the association between household living conditions and the occurrence of asymptomatic malaria in the lowlands of Ethiopia.
A community-based cross-sectional study was conducted from January to March 2021 in twelve villages of Gambella, Southern Nation Nationalities and People Region and Afar in Ethiopia. A total of 1366 households were randomly selected, interviewed, and tested for malaria by rapid diagnostic test and blood film microscopic examination. Multiple logistic regression model was used to determine the independent association between living conditions and asymptomatic malaria infection.
The prevalence of asymptomatic malaria infection among individuals living in dwellings built with traditional floor/wall/roof ranges from 8.1% to 8.4% while it ranges from 2.0% to 4.6% among those living in modern floor/wall/roof houses. Dwellings built with traditional wall materials (P = 0.050), spending nights with cattle in the same house (P < 0.001), and availability of kitchen in the main house with no partition (P = 0.004) were significantly associated with asymptomatic malaria infection.
Asymptomatic malaria infection was 4.3 times higher among occupants residing in dwellings built with traditional wall materials; 5.6 times higher among households spending nights with cattle in the same house, and 2.3 times higher among households with kitchen in the main house with no partition. Therefore, policies and strategies on malaria elimination need to address or target improvements of the above listed living conditions for the community. A multi sectoral action is required to use these social determinants as a vector control strategic addition; and malaria elimination programs are expected to coordinate the implementation.
在以前疟疾负担较高的非洲国家，疟疾负担显著下降。尽管全球疟疾负担的下降幅度很大，但通常 95%的下降发生在 29 个非洲国家，而 2020 年的 COVID-19 对下降产生了影响。由于采取了有效的预防和治疗措施，以及生活条件的迅速变化，疟疾发病率显著下降。无症状疟原虫感染的发生与家庭生活条件之间的关系尚未得到充分研究。本研究旨在确定埃塞俄比亚低地家庭生活条件与无症状疟疾发生之间的关系。
2021 年 1 月至 3 月，在埃塞俄比亚南部的 Gambella、南埃塞俄比亚民族和人民地区和 Afar 的 12 个村庄进行了一项基于社区的横断面研究。共随机选择了 1366 户家庭，通过快速诊断检测和血片显微镜检查对他们进行了疟疾访谈和检测。采用多因素逻辑回归模型来确定生活条件与无症状疟疾感染之间的独立关系。
居住在传统地板/墙壁/屋顶房屋的人群中，无症状疟原虫感染的流行率在 8.1%至 8.4%之间，而居住在现代地板/墙壁/屋顶房屋的人群中，流行率在 2.0%至 4.6%之间。使用传统墙壁材料建造的房屋（P=0.050）、与牛同睡一个房间（P<0.001）和主屋没有隔板的厨房（P=0.004）与无症状疟原虫感染显著相关。
居住在传统墙壁材料建造的房屋中的居民中，无症状疟原虫感染的风险高 4.3 倍；与牛同睡一个房间的家庭中，风险高 5.6 倍；主屋没有隔板的厨房的家庭中，风险高 2.3 倍。因此，消除疟疾的政策和战略需要解决或针对改善上述生活条件，作为一种增加控制战略；消除疟疾方案预计将协调实施。
