Department of Medical Parasitology, University Cheikh Anta Diop of Dakar, Dakar, Senegal.
Institut en Santé et Développement, University Cheikh Anta Diop of Dakar, Dakar, Senegal.
PLoS One. 2024 May 16;19(5):e0303794. doi: 10.1371/journal.pone.0303794. eCollection 2024.
In Senegal, the widespread use of vector control measures has resulted in a significant reduction in the malaria burden and led the country to consider the possibility of elimination. Given this shift and changing context, it is important to characterize the malaria burden across all age groups to guide decision-making on programmatic interventions to interrupt transmission and ultimately eradicate the disease. In Senegal, there is a lack of information on malaria prevalence among certain populations, particularly among adolescents and adults. This study sought to assess the magnitude of malaria infections in all age groups, as well as malaria associated factors in an area of persistent transmission in Senegal.
A cross-sectional household survey was conducted in four health posts (Khossanto, Mamakhona, Diakhaling and Sambrambougou), of the health district of Saraya, in November 2021, among individuals over 6 months of age. Households were selected using multistage sampling. Consented participants were screened for malaria parasites by microscopic examination of blood smears, and hemoglobin levels were measured using the Hemocue HB 301TM analyzer. Socio-demographic information of the participants, household heads, household assets, and information on ownership and use of preventive measures were collected using a structured questionnaire. Weighted generalized mixed effects logistic regression model was used to identify factors associated with microscopically confirmed malaria infection.
A total of 1759 participants were enrolled in the study. Overall, about 21% of participants were classified as having Plasmodium infection; children aged 5-10 years old (26.6%), adolescents aged 10-19 years old (24.7%), and children under five years of age (20.5%) had higher rates of infection compared to adults (13.5%). Plasmodium falciparum accounted for 99.2% of the malaria infections, and most infections (69%) were asymptomatic. Around one-third of study participants had anemia (hemoglobin level <11.0 g/dl), with under five children bearing the highest burden (67.3%). Multivariate analysis showed that the odds of having a malaria infection were around 2 times higher among participants in Khossanto compared to Diakhaling (aOR = 1.84, 95% CI:1.06-3.20). Participants aged 5-9 years were more likely to have malaria infection compared to under five children (aOR = 1.40, 95% CI:1.02-1.91). Factors associated with anemia were P. falciparum infection (aOR = 1.36, p = 0.027), females (aOR = 2.16, p = 0.000), under-five age group (aOR = 13.01, p = 0.000).
Malaria burden was considerable among adolescents and under ten children living in an area of persistent transmission, with adolescents more commonly presenting as asymptomatic. Interventions tailored to this specific group of the population are needed to better control the disease and reduce its burden.
在塞内加尔,广泛使用的病媒控制措施已显著降低了疟疾负担,并促使该国考虑消除疟疾的可能性。鉴于这种转变和不断变化的背景,有必要对所有年龄段的疟疾负担进行特征描述,以指导针对中断传播和最终消灭该疾病的规划干预措施的决策。在塞内加尔,某些人群(特别是青少年和成年人)的疟疾患病率信息不足。本研究旨在评估所有年龄段人群中疟疾感染的程度,以及塞内加尔持续传播地区与疟疾相关的因素。
2021 年 11 月,在萨拉亚行政区的四个卫生站(Khossanto、Mamakhona、Diakhaling 和 Sambrambougou)进行了一项横断面家庭调查,对象为 6 个月以上的个体。使用多阶段抽样选择家庭。同意的参与者通过显微镜检查血涂片筛查疟原虫,使用 Hemocue HB 301TM 分析仪测量血红蛋白水平。使用结构化问卷收集参与者、户主的社会人口学信息、家庭资产以及关于预防措施的拥有和使用情况。使用加权广义混合效应逻辑回归模型确定与显微镜确认的疟疾感染相关的因素。
共有 1759 名参与者参加了这项研究。总体而言,约 21%的参与者被归类为存在疟原虫感染;5-10 岁儿童(26.6%)、10-19 岁青少年(24.7%)和 5 岁以下儿童(20.5%)的感染率高于成年人(13.5%)。恶性疟原虫感染占疟疾感染的 99.2%,大多数感染(69%)为无症状。大约三分之一的研究参与者患有贫血症(血红蛋白水平<11.0 g/dl),5 岁以下儿童负担最重(67.3%)。多变量分析显示,与 Diakhaling 相比,Khossanto 参与者的疟疾感染几率约高 2 倍(调整比值比[aOR] = 1.84,95%置信区间:1.06-3.20)。与 5 岁以下儿童相比,5-9 岁儿童更有可能感染疟疾(调整比值比[aOR] = 1.40,95%置信区间:1.02-1.91)。与贫血症相关的因素是恶性疟原虫感染(调整比值比[aOR] = 1.36,p = 0.027)、女性(调整比值比[aOR] = 2.16,p = 0.000)、5 岁以下年龄组(调整比值比[aOR] = 13.01,p = 0.000)。
在持续传播地区,青少年和 10 岁以下儿童的疟疾负担相当大,青少年更常表现为无症状。需要针对这一特定人群的具体干预措施,以更好地控制疾病并减轻其负担。