Tetteh John, Yorke Ernest, Boima Vincent, Yawson Alfred Edwin
Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana.
Department of Medicine and Therapeutics, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana.
Parasite Epidemiol Control. 2023 Apr 28;21:e00302. doi: 10.1016/j.parepi.2023.e00302. eCollection 2023 May.
To assess the prevalence of malaria infection and further quantify the impact of mosquito bed net distribution on malaria infection among children aged 6-59 months in Ghana.
A cross-sectional study using Ghana Demographic Health (GDHS) and Malaria Indicator (GMIS) surveys (2014 GDHS, 2016 GMIS, and 2019 GMIS). The exposure and the main outcomes were mosquito bed net use (MBU) and malaria infection (MI). Relative percentage change (Δ) and prevalence ratio (PR) were estimated to assess the changes and the risk of MI by MBU respectively. The Propensity-score matching treatment effect model was employed to estimate the average treatment effect (ATE) of MBU on MI. All analyses were performed using Stata 16.1 and -value<0.05 was deemed significant.
The study involved 8781 children aged 6-59 months. MI ranged from 25.8%(22.3-29.7) in 2019 GMIS to 40.6%(37.0-44.2) in 2014 GDHS and the prevalence was significantly high among children who used mosquito bed net. The relative percentage change in MI prevalence showed a significant reduction rate and was high among non-MBU (-value<0.05). In all, the adjusted PR of MI among children exposed to MBU was 1.21(1.08-1.35), 1.13(1.01-1.28), and 1.50(1.20-1.75) in 2014 GDHS, 2016 GMIS, and 2019 GMIS respectively. The average MI among participants who slept in mosquito bed net significantly increased by 8%(0.04 to 0.12), 4%(0.003 to 0.08), and 7%(0.03 to 0.11) in 2014 GDHS, 2016 GMIS, and 2019 GMIS respectively.
Even though malaria infection prevalence among children aged 6-59 months is decreasing, the reduction rate seems not to be directly linked with mosquito bed nets distribution and/or use in Ghana. For a continued distribution of mosquito bed nets, and for Ghana to achieve her program managers should ensure effective use of the distributed nets in addition to other preventive measures and nuanced consideration of community behaviours in Ghana. The effective use and care of bed nets should be emphasized as part of the distribution.
评估加纳6至59个月儿童疟疾感染的流行情况，并进一步量化蚊帐分发对疟疾感染的影响。
采用加纳人口健康调查（GDHS）和疟疾指标调查（GMIS）（2014年GDHS、2016年GMIS和2019年GMIS）进行横断面研究。暴露因素和主要结局分别是蚊帐使用情况（MBU）和疟疾感染（MI）。分别估计相对百分比变化（Δ）和患病率比（PR），以评估MBU导致的MI变化和风险。采用倾向得分匹配治疗效果模型估计MBU对MI的平均治疗效果（ATE）。所有分析均使用Stata 16.1进行，P值<0.05被视为具有统计学意义。
该研究纳入了8781名6至59个月的儿童。MI患病率从2019年GMIS的25.8%（22.3 - 29.7）到2014年GDHS的40.6%（37.0 - 44.2）不等，在使用蚊帐的儿童中患病率显著较高。MI患病率的相对百分比变化显示出显著的降低率，在未使用蚊帐的儿童中该降低率较高（P值<0.05）。总体而言，2014年GDHS、2016年GMIS和2019年GMIS中，接触MBU的儿童的MI调整后PR分别为1.21（1.08 - 1.35）、1.13（1.01 - 1.28）和1.50（1.20 - 1.75）。在2014年GDHS、2016年GMIS和2019年GMIS中，睡在蚊帐中的参与者的平均MI分别显著增加了8%（0.04至0.12）、4%（0.003至0.08）和7%（0.03至0.11）。
尽管6至59个月儿童的疟疾感染患病率在下降，但在加纳，下降率似乎与蚊帐的分发和/或使用没有直接关联。为了继续分发蚊帐，以及加纳要实现其……项目管理者除了采取其他预防措施外，还应确保有效使用分发的蚊帐，并对加纳的社区行为进行细致考虑。应强调有效使用和保养蚊帐是分发工作的一部分。
