Department of Environmental Health, Faculty of Public Health, Kampus Baru Depok, Universitas Indonesia, Kota Depok 16424, Jawa Barat, Indonesia.
Environmental Health Department, Ministry of Health and Child Care, Kaguvi Building, 4th Floor, Causeway, Harare P.O. Box CY 1122, Zimbabwe.
Int J Environ Res Public Health. 2024 Jul 4;21(7):877. doi: 10.3390/ijerph21070877.
Malaria has created a resurgence crisis in Zimbabwe's elimination continuum, diverging from global commitment to malaria elimination by 2030. This retrospective cohort study aimed to determine the risk factors associated with severe malaria in the Beitbridge and Lupane districts. Multistage sampling was used to recruit 2414 individuals recorded in the District Health Information Software2 Tracker database. The study used IBM SPSS 29.0.2.0(20) for data analysis, and odds ratios (ORs) to estimate the relative risk (RR; 95% C.I; < 0.05). The study revealed significant relative risks (-value < 0.05) for individuals who had no Long-Lasting Insecticidal Nets (Beitbridge 47.4; Lupane 12.3), those who owned but used the LLINs (Beitbridge 24.9; Lupane 7.83), those who slept outdoors during the night (Beitbridge 84.4; Lupane 1.93), and adults (Beitbridge 0.18; Lupane 0.22) compared to the corresponding reference groups. Other factors showed varying RR: sex (Beitbridge 126.1), prompt treatment (Beitbridge 6.78), hosting visitor(s) (Lupane 6.19), and residence (Lupane 1.94) compared to the corresponding reference groups. Risk factor management needs to focus on increasing local awareness of malaria, universal LLINs coverage of indoor and outdoor sleeping spaces, community-based programs on proper and consistent LLIN usage, screening of visitors from malaria-endemic areas, comprehensive entomological activities, mixed malaria interventions in rural hotspots, and future research on local malaria transmission dynamics. While Zimbabwe has the potential to meet the global goal of malaria elimination, success depends on overcoming the risk factors to sustain the gains already made among malaria elimination districts.
疟疾在津巴布韦消除工作的延续性方面造成了死灰复燃的危机，偏离了全球到 2030 年消除疟疾的承诺。本回顾性队列研究旨在确定比蒂桥和卢帕内地区严重疟疾的相关风险因素。采用多阶段抽样方法从 District Health Information Software2 Tracker 数据库中招募了 2414 名记录在册的个体。研究使用 IBM SPSS 29.0.2.0(20) 进行数据分析，使用优势比（OR）估计相对风险（RR；95%置信区间；<0.05）。研究表明，没有长效驱虫蚊帐的个体（比蒂桥 47.4；卢帕内 12.3）、拥有但使用 LLINs 的个体（比蒂桥 24.9；卢帕内 7.83）、夜间在户外睡觉的个体（比蒂桥 84.4；卢帕内 1.93）和成年人（比蒂桥 0.18；卢帕内 0.22）与相应的参考组相比，具有显著的相对风险（-值<0.05）。其他因素显示出不同的 RR：性别（比蒂桥 126.1）、及时治疗（比蒂桥 6.78）、接待访客（卢帕内 6.19）和居住地（卢帕内 1.94）与相应的参考组相比。风险因素管理需要重点提高当地对疟疾的认识、普及室内和室外睡眠空间的长效驱虫蚊帐、以社区为基础的关于正确和一致使用 LLINs 的方案、对来自疟疾流行地区的访客进行筛查、全面开展昆虫学活动、在农村热点地区实施混合疟疾干预措施以及对当地疟疾传播动态进行未来研究。虽然津巴布韦有潜力实现全球消除疟疾的目标，但成功取决于克服风险因素，以维持在消除疟疾地区已经取得的成果。
