Gobe Dejene Edessa, Mohammed Ahmed, Adem Abdurezak, Deribe Kebede, Chernet Afona, Yared Solomon
College of Medicine and Health, Science, Jigjiga University, Jigjiga, Ethiopia.
College of Medicine and Health Science, Dire Dawa University, Dire Dawa, Ethiopia.
Malar J. 2024 Dec 19;23(1):393. doi: 10.1186/s12936-024-05206-4.
Despite significant efforts to control malaria infections in recent years, new infection rates continue to pose a major public health challenge in sub-Saharan Africa, including Ethiopia. This study aims to identify the key factors of malaria infection among children under five years (U5) in the Gursum district of Somali region, Eastern Ethiopia.
An institution-based case-control study was conducted over two months, from June to July 2020. The study included 247 participants, divided into 82 cases and 165 controls, with a case-to-control ratio of 1:2. It focused on households with children under the age of five who received care at three health centers within the district. The investigation involved identifying Plasmodium species using rapid diagnostic tests and microscopic blood film examination. A logistic regression model was employed to analyze the factors affecting the outcome, using statistical software STATA-13/15. Odds ratios and the corresponding confidence intervals were calculated to identify potential predictors in the logistic regression model.
A multivariate analysis identified five exposures significantly associated with malaria positivity among children: living near a source of water [adjusted odds ratio (AOR) = 3.60 (1.73-7.48)], residing in rural areas [AOR = 3.58 (1.56-8.21)], living in houses with openings or holes in the walls that facilitate mosquito entry [AOR = 5.00 (2.22-11.28)], and not receiving malaria health information [AOR = 2.12 (1.06-4.21)]. Additionally, proximity to malaria vector breeding habitats [AOR = 4.74 (2.27-9.90)] was significant for malaria positivity. These five factors emerged as the primary determinants of malaria positivity among U5 children in the Gursum district.
The study indicates that critical factors contributing to malaria positivity among U5 children in the Gursum district are related to a lack of awareness, housing conditions, and proximity to vector breeding sites. Therefore, social mobilization and targeted malaria interventions at the community level are essential for reducing disease transmission, particularly among the most vulnerable children.
尽管近年来在控制疟疾感染方面付出了巨大努力，但新感染率在撒哈拉以南非洲地区（包括埃塞俄比亚）仍然是一个重大的公共卫生挑战。本研究旨在确定埃塞俄比亚东部索马里州古尔苏姆区五岁以下儿童疟疾感染的关键因素。
2020年6月至7月，进行了一项为期两个月的基于机构的病例对照研究。该研究包括247名参与者，分为82例病例和165名对照，病例与对照比例为1:2。研究重点是该地区三个卫生中心内有五岁以下儿童接受护理的家庭。调查包括使用快速诊断测试和显微镜血涂片检查来识别疟原虫种类。使用统计软件STATA-13/15，采用逻辑回归模型分析影响结果的因素。计算比值比和相应的置信区间，以确定逻辑回归模型中的潜在预测因素。
多变量分析确定了与儿童疟疾阳性显著相关的五个暴露因素：居住在水源附近[调整后的比值比（AOR）=3.60（1.73-7.48）]、居住在农村地区[AOR=3.58（1.56-8.21）]、居住在墙壁上有开口或洞便于蚊子进入的房屋中[AOR=5.00（2.22-11.28）]以及未获得疟疾健康信息[AOR=2.12（1.06-4.21）]。此外，靠近疟疾媒介繁殖栖息地[AOR=4.74（2.27-9.90）]对疟疾阳性也有显著影响。这五个因素成为古尔苏姆区五岁以下儿童疟疾阳性的主要决定因素。
该研究表明，古尔苏姆区五岁以下儿童疟疾阳性的关键因素与缺乏认识、住房条件以及靠近媒介繁殖地点有关。因此，社会动员和社区层面有针对性的疟疾干预措施对于减少疾病传播至关重要，特别是在最脆弱的儿童中。
