Vector Control Product Testing Unit (VCPTU) Ifakara Health Institute, Environmental Health, and Ecological Sciences, Bagamoyo, Tanzania.
Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Tanzania.
PLoS One. 2023 Dec 21;18(12):e0295800. doi: 10.1371/journal.pone.0295800. eCollection 2023.
After a decade of successful control, malaria is on the rise again. The prevalence of malaria in Tanzania has increased from 7% in 2017 to 8% in 2022 and reached 18% in Kagera region in the North West of Tanzania. Malaria vectors in Muleba district Kagera have high level of pyrethroid resistance. The aim of this paper is to explore factors associated with malaria infection prevalence in children aged 6 months to 14 years in Muleba, where Long Lasting Insecticidal Net (LLIN) combining a pyrethroid insecticide and synergist piperonyl butoxide (PBO) that counteract resistance in the mosquitoes, was first distributed under trial conditions in 2015.
The trial was a community randomized control in which there were two malaria prevalence cross-sectional household surveys each year (June and December) from 2015 to 2017 in Muleba. In this study we conducted a secondary data analysis of the December surveys only. Multilevel Poisson regression analysis was used to assess factors associated with malaria infection.
A total of 10,941 children and 4,611 households were included in this study. Overall malaria prevalence was 35.8%, 53.3% and 54.4% in the year 2015, 2016 and 2017 respectively. Living in an area with standard LLIN as opposed to the novel PBO synergist LLIN, being a male child, above 5 years of age, living in a house with open eaves, living in house without IRS, having head of household with no formal education, lower socioeconomic status and survey year were associated with increased risk of malaria infection.
Using PBO LLIN reduced the risk of malaria infection. However, additional measures could further reduce malaria infection in areas of insecticide resistance such as housing improvement.
在成功控制疟疾十年后，该疾病的发病率再次上升。坦桑尼亚的疟疾发病率已从 2017 年的 7%上升至 2022 年的 8%，在坦桑尼亚西北部的卡盖拉地区已达到 18%。姆莱巴区的疟疾传播媒介对拟除虫菊酯的耐药性水平很高。本文旨在探讨姆莱巴地区（2015 年首次试用添加增效剂增效醚的长效驱虫蚊帐）6 个月至 14 岁儿童疟疾感染率的相关因素。
该试验为社区随机对照试验，2015 年至 2017 年期间，每年 6 月和 12 月进行两次疟疾患病率横断面家庭调查。本研究仅对 12 月的调查进行二次数据分析。多水平泊松回归分析用于评估与疟疾感染相关的因素。
本研究共纳入 10941 名儿童和 4611 户家庭。2015 年、2016 年和 2017 年，总体疟疾患病率分别为 35.8%、53.3%和 54.4%。与使用新型增效醚长效驱虫蚊帐相比，使用标准长效驱虫蚊帐、男孩、5 岁以上、房屋有敞开屋檐、房屋未进行室内残留喷洒、户主未接受正规教育、社会经济地位较低以及调查年份与疟疾感染风险增加相关。
使用增效醚长效驱虫蚊帐可降低疟疾感染风险。然而，在杀虫剂耐药地区，如改善住房条件等，还可以采取额外措施进一步降低疟疾感染率。
