Wångdahl Andreas, Bogale Rebecca Tafesse, Eliasson Isabelle, Broumou Ioanna, Faroogh Fariba, Lind Filip, Vashchuk Ganna, Hildell Adina, Franson Suzanne, Hallberg Emil, Grip Isabelle, Nordling Irene, Gervin Angelica, Kaitoly Shelan, Tekleab Berhane, Wyss Katja, Requena-Méndez Ana, Hertting Olof, Färnert Anna
Division of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
Department of Infectious Diseases, Västerås Hospital, Västerås, Sweden.
Lancet Reg Health Eur. 2023 Jan 13;27:100581. doi: 10.1016/j.lanepe.2022.100581. eCollection 2023 Apr.
Asymptomatic infections with malaria parasites are common in populations in endemic areas. These infections may persist in migrants after arrival in a non-endemic area. Screening to find and clear these infections is generally not implemented in non-endemic countries, despite a potential negative health impact. We performed a study to evaluate the parasite prevalence in migrants living in Sweden.
Adults and children born in Sub-Saharan Africa (SSA) were invited in the study between April 2019 and June 2022 at 10 different sites, mainly as part of the national Migrant Health Assessment Program in Stockholm and Västerås, Sweden. Rapid diagnostic tests (RDT) and real-time PCR were used to detect malaria parasites. Prevalence and test sensitivity were calculated with 95% confidence intervals (CI). Univariate and multivariable logistic regression were used to evaluate associations with PCR positivity.
In total, 789 individuals were screened for spp. of which 71 (9.0%) were positive by PCR and 18 (2.3%) also by RDT. When performed during the national screening program, 10.4% was PCR positive. A high prevalence was detected in migrants with Uganda as the country of last residence, 53/187 (28.3%), and in this group the prevalence was highest in children, 29/81 (35.8%). Among the PCR positive, 47/71 (66.2%) belonged to families with at least one other member testing positive (odds ratio [OR] 43.4 (95% CI 19.0-98.9), and the time lived in Sweden ranged between 6 and 386 days.
A high malaria parasite prevalence was found in migrants from SSA, particularly in children offered screening in Stockholm, Sweden during the study period. Awareness of asymptomatic malaria infection is needed and screening for malaria in migrants arriving from high endemic countries should be considered.
The Swedish Research Council, Stockholm County Council and Centre for Clinical Research, Västmanland, Sweden.
在疟疾流行地区的人群中，疟原虫无症状感染很常见。这些感染在移民抵达非流行地区后可能会持续存在。尽管可能对健康有负面影响，但非流行国家通常不进行筛查以发现和清除这些感染。我们开展了一项研究，以评估居住在瑞典的移民中的疟原虫感染率。
2019年4月至2022年6月期间，在10个不同地点邀请了出生在撒哈拉以南非洲（SSA）的成人和儿童参与研究，主要作为瑞典斯德哥尔摩和韦斯特罗斯国家移民健康评估项目的一部分。使用快速诊断测试（RDT）和实时PCR检测疟原虫。计算感染率和检测灵敏度，并给出95%置信区间（CI）。采用单变量和多变量逻辑回归评估与PCR阳性的相关性。
总共对789人进行了疟原虫筛查，其中71人（9.0%）PCR检测呈阳性，18人（2.3%）RDT检测也呈阳性。在国家筛查项目期间进行检测时，10.4%的人PCR呈阳性。在最后居住国为乌干达的移民中检测到的感染率很高，为53/187（28.3%），且该群体中儿童的感染率最高，为29/81（35.8%）。在PCR检测呈阳性的人中，47/71（66.2%）属于至少有一名其他家庭成员检测呈阳性的家庭（比值比[OR]为43.4（95%CI为19.0 - 98.9）），在瑞典居住的时间为6至386天。
在撒哈拉以南非洲移民中发现了较高的疟原虫感染率，尤其是在研究期间于瑞典斯德哥尔摩接受筛查的儿童中。需要提高对无症状疟疾感染的认识，并且应考虑对来自高流行国家的移民进行疟疾筛查。
瑞典研究理事会、斯德哥尔摩郡议会和瑞典韦斯特曼兰临床研究中心。
