Cheikh Anta Diop University, Dakar, Senegal.
University of Ndjamena, Ndjamena, Chad.
BMC Public Health. 2024 Mar 28;24(1):918. doi: 10.1186/s12889-024-18454-5.
In Chad, malaria remains a significant public health concern, particularly among nomadic populations. Geographical factors and the mobility of human populations have shown to be associated with the diversity of Plasmodium species. The study aims to describe the malaria prevalence among nomadic children and to investigate its associated factors.
A cross-sectional study was conducted in February and October 2021 among nomadic communities in Chad. Blood sample were collected and tested from 187 Arab, Fulani and Dazagada nomadic children aged 3-59 months using malaria rapid diagnostic test (RDT). A structured electronic questionnaire was administered to their parents to collect information about the socio‑economic data. Malaria testing results were categorized according to the SD BIOLINE Malaria Ag Pf/Pan RDT procedures. Logistic regression analysis was used to determine key risk factors explaining the prevalence of malaria. STATA version IC 13 was used for statistical analysis.
The overall malaria prevalence in nomadic children was 24.60%, with 65.20% being Plasmodium falciparum species and 34.8% mixed species. Boys were twice as likely (COR = 1.83; 95% CI, 0.92-3.62; p = 0.083) to have malaria than girls. Children whose parents used to seek traditional drugs were five times more likely (AOR = 5.59; 95% CI, 1.40-22.30, p = 0.015) to have malaria than children whose parents used to seek health facilities. Children whose parents reported spending the last night under a mosquito net were one-fifth as likely (AOR = 0.17; 95% CI, 0.03-0.90, p = 0.037) to have malaria compared to children whose parents did not used a mosquito net. Furthermore, Daza children were seventeen times (1/0.06) less likely (AOR = 0.06; 95% CI, 0.01-0.70, p = 0.024) to have malaria than Fulani children and children from households piped water as the main source were seven times more likely (AOR = 7.05; 95% CI, 1.69-29.45; p = 0.007) to have malaria than those using surface water.
Malaria remains a significant public health issue in the nomadic communities of Chad. Community education and sensitization programs within nomad communities are recommended to raise awareness about malaria transmission and control methods, particularly among those living in remote rural areas. The National Malaria Control Program (NMCP) should increase both the coverage and use of long-lasting insecticidal nets (LLINs) and seasonal malaria chemoprevention (SMC) in addition to promoting treatment-seeking behaviors in nomadic communities.
在乍得，疟疾仍然是一个严重的公共卫生问题，特别是在游牧人群中。地理因素和人口的流动性已被证明与疟原虫种类的多样性有关。本研究旨在描述游牧儿童的疟疾流行情况，并探讨其相关因素。
2021 年 2 月和 10 月在乍得的游牧社区进行了一项横断面研究。使用疟疾快速诊断检测（RDT）对 187 名年龄在 3-59 个月的阿拉伯、富拉尼和达扎加达游牧儿童采集血样进行检测。对其父母进行了结构化的电子问卷调查，以收集社会经济数据。疟疾检测结果根据 SD BIOLINE 疟疾 Ag Pf/Pan RDT 程序进行分类。使用逻辑回归分析确定解释疟疾流行的关键风险因素。使用 STATA 版本 IC 13 进行统计分析。
游牧儿童的总体疟疾患病率为 24.60%，其中 65.20%为恶性疟原虫，34.8%为混合物种。男孩患疟疾的可能性是女孩的两倍（COR=1.83；95%CI，0.92-3.62；p=0.083）。与父母常去医疗机构的儿童相比，父母常去寻求传统药物的儿童患疟疾的可能性高 5 倍（AOR=5.59；95%CI，1.40-22.30，p=0.015）。与父母未使用蚊帐的儿童相比，报告最后一晚在蚊帐下的儿童患疟疾的可能性低五分之一（AOR=0.17；95%CI，0.03-0.90，p=0.037）。此外，与富拉尼儿童相比，Daza 儿童患疟疾的可能性低 17 倍（AOR=0.06；95%CI，0.01-0.70，p=0.024），与以自来水为主要水源的家庭儿童相比，前者患疟疾的可能性高 7 倍（AOR=7.05；95%CI，1.69-29.45；p=0.007）。
疟疾仍然是乍得游牧社区的一个重大公共卫生问题。建议在游牧社区内开展社区教育和宣传计划，提高对疟疾传播和控制方法的认识，特别是在偏远农村地区。国家疟疾控制规划（NMCP）应增加长效驱虫蚊帐（LLIN）和季节性疟疾化学预防（SMC）的覆盖率和使用率，并促进游牧社区的治疗寻求行为。
