Joe C. Wen School of Population and Public Health, College of Health Sciences, University of California at Irvine, Irvine, CA, 92697, USA.
School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.
Malar J. 2024 Sep 30;23(1):292. doi: 10.1186/s12936-024-05117-4.
Malaria is a major disease burden in Ethiopia. Migration can influence malaria transmission dynamics, with individuals relocating from malaria-free highland regions to malarious lowlands potentially facing elevated risks of contracting malaria. Migrants may find it difficult to protect themselves against malaria and have limited access to diagnosis or treatment. Settlers in gold mining sites are one type of migrant and are often neglected in malaria research yet may have particularly high malaria risk. This study was a malaria prevalence survey among settlers in a new gold mining settlement in the highly malarious Gambella Region, Ethiopia.
n = 590 people were surveyed for demographic information and their knowledge and practices of malaria. Participants were tested for malaria using rapid diagnostic tests and microscopy. Using logistic regressions, the influence of demographic characteristics on malaria infections and bed net access were analysed. A sub-sample of participants was interviewed to comprehend settlement living conditions and healthcare accessibility.
The overall prevalence of Plasmodium falciparum was 37.5% (CI 32.4-42.3%). Young children were most likely to have malaria, with individuals aged 15-24 having 67% lower odds (aOR: 0.33; CI 0.13-0.86) of infection compared to those aged 1-4 years old. Meanwhile, those age 25-plus had 75% decreased odds of malaria infection (aOR 0.25; CI 0.10-0.65). Individuals with bed nets had ~ 50% decreased odds of testing positive for falciparum malaria than those reporting having no bed net (aOR: 0.47; CI 0.22-0.97). Individuals who relocated from low elevation with high malaria test positivity rate areas were more prone to testing positive for malaria, as were those residing in densely populated households with multiple malaria cases. Conversely, individuals from higher elevations with low malaria test positivity rates, and those living in households with 5-10 occupants and < 2 malaria infections, were more likely to possess bed nets.
This gold mining settlement provides an example of an oft-neglected atypical community where malaria is a significant, but under-addressed, health problem. Within this community, future interventions focused on distributing bed nets, particularly to larger households and those with children, have great potential to alleviate the malaria burden. Efforts should also be made to provide affordable, and accessible, early diagnosis and treatment.
疟疾是埃塞俄比亚的一个主要疾病负担。迁移可能会影响疟疾传播动态,从无疟疾的高地地区迁移到疟疾流行的低地地区的个人可能面临更高的疟疾感染风险。移民可能难以保护自己免受疟疾的侵害,并且获得诊断或治疗的机会有限。在金矿开采点的定居者是一种移民,他们在疟疾研究中经常被忽视,但可能面临特别高的疟疾风险。本研究是在埃塞俄比亚高度疟疾流行的甘贝拉地区一个新的金矿开采定居点对定居者进行的疟疾患病率调查。
对 590 人进行了调查,以了解他们的人口统计学信息以及他们对疟疾的了解和实践。使用快速诊断测试和显微镜对参与者进行疟疾检测。使用逻辑回归分析人口统计学特征对疟疾感染和蚊帐获取的影响。对参与者的一个子样本进行了访谈,以了解定居点的生活条件和医疗保健的可及性。
总体上,恶性疟原虫的流行率为 37.5%(95%CI 32.4-42.3%)。幼儿最有可能感染疟疾,年龄在 15-24 岁的人感染疟疾的可能性降低 67%(调整后的优势比[aOR]:0.33;95%CI 0.13-0.86),而年龄在 1-4 岁的人感染疟疾的可能性降低 67%。同时,25 岁以上的人感染疟疾的可能性降低 75%(aOR 0.25;95%CI 0.10-0.65)。有蚊帐的人感染恶性疟原虫的几率比报告没有蚊帐的人低约 50%(aOR:0.47;95%CI 0.22-0.97)。从疟疾检测阳性率较高的低海拔地区迁移而来的人更容易检测出疟疾阳性,而居住在人口密集、有多个疟疾病例的家庭中的人也是如此。相反,来自疟疾检测阳性率较低的高海拔地区的人,以及居住在有 5-10 名居民和/或感染疟疾次数 < 2 次的家庭中的人,更有可能拥有蚊帐。
这个金矿开采定居点是一个经常被忽视的非典型社区的例子,在这个社区中,疟疾是一个严重但未得到充分解决的健康问题。在这个社区中,未来的干预措施应重点分发蚊帐,特别是向较大的家庭和有儿童的家庭分发,这将极大地减轻疟疾负担。还应努力提供负担得起且可获得的早期诊断和治疗。