Chacha Gervas A, Francis Filbert, Mandai Salehe S, Seth Misago D, Madebe Rashid A, Challe Daniel P, Petro Daniel A, Pereus Dativa, Moshi Ramadhani, Budodo Rule, Kisambale Angelina J, Mbwambo Ruth B, Bakari Catherine, Aaron Sijenunu, Mbwambo Daniel, Kajange Stella, Lazaro Samuel, Kapologwe Ntuli, Mandara Celine I, Ishengoma Deus S
National Institute for Medical Research, Dar es Salaam, Tanzania.
National Institute for Medical Research, Tanga Research Centre, Tanga, Tanzania.
Parasit Vectors. 2025 Jan 24;18(1):24. doi: 10.1186/s13071-024-06639-1.
Despite implementation of effective interventions in the past two decades, malaria is still a major public health problem in Tanzania. This study assessed the prevalence and drivers of malaria infections among symptomatic and asymptomatic members of selected communities from five regions with varying endemicity in mainland Tanzania.
A cross-sectional community survey was conducted in five districts, including one district/region in Kagera, Kigoma, Njombe, Ruvuma and Tanga from July to August 2023. Participants aged ≥ 6 months were recruited and tested using rapid diagnostic tests (RDTs). Demographic, anthropometric, clinical, parasitological, type of house, and socio-economic status (SES) data were captured using structured questionnaires. Associations between parasite prevalence and potential drivers were determined by logistic regression, and the results were presented as crude (cOR) and adjusted odds ratios (aOR), with 95% confidence intervals (CIs).
Among 10,228 individuals tested, 3515 (34.4%) had positive results by RDTs. The prevalence of malaria varied from 21.6% in Tanga to 44.4% in Kagera, and from 14.4% to 68.5% among the different villages (P < 0.001). The odds of malaria infections were higher in males (aOR = 1.32, 95% CI 1.19-1.48, P < 0.001), under-fives (aOR = 2.02, 95% CI 1.74-2.40, P < 0.001), schoolchildren [aged 5-9 years (aOR = 3.23, 95% CI 1.19-1.48, P < 0.001) and 10-14 years (aOR = 3.53, 95% CI 3.03-4.11, P < 0.001)], and non-bednet users (aOR = 1.49, 95% CI 1.29-1.72, P < 0.001). Individuals from households with low SES (aOR = 1.40, 95% CI 1.16-1.69, P < 0.001), or living in houses with open windows (aOR = 1.24, 95% CI 1.06-1.45, P < 0.001) and/or holes on the walls (aOR = 1.43, 95% CI 1.14-1.81, P < 0.001) also had higher odds.
Malaria prevalence varied widely across regions and villages, and the odds of infections were higher in males, schoolchildren, non-bednet users, and individuals with low SES or living in houses with open windows and/or holes on the walls. The identified vulnerable groups and hotspots should be targeted with specific interventions to reduce the disease burden and support the ongoing malaria elimination efforts in Tanzania.
尽管在过去二十年中实施了有效的干预措施，但疟疾仍是坦桑尼亚的一个主要公共卫生问题。本研究评估了坦桑尼亚大陆五个流行程度不同地区选定社区中有症状和无症状人群的疟疾感染率及驱动因素。
2023年7月至8月，在五个地区开展了一项横断面社区调查，这五个地区包括卡盖拉、基戈马、恩琼贝、鲁伍马和坦噶各一个区。招募年龄≥6个月的参与者，并使用快速诊断检测（RDT）进行检测。使用结构化问卷收集人口统计学、人体测量学、临床、寄生虫学、房屋类型和社会经济地位（SES）数据。通过逻辑回归确定寄生虫感染率与潜在驱动因素之间的关联，结果以粗比值比（cOR）和调整后的比值比（aOR）表示，并给出95%置信区间（CI）。
在接受检测的10228人中，3515人（34.4%）RDT检测结果呈阳性。疟疾感染率在坦噶为21.6%，在卡盖拉为44.4%，在不同村庄之间为14.4%至68.5%（P<0.001）。男性（aOR = 1.32，95%CI 1.19 - 1.48，P<0.001）、五岁以下儿童（aOR = 2.02，95%CI 1.74 - 2.40，P<0.001）、学童[5 - 9岁（aOR = 3.23，95%CI 1.19 - 1.48）和10 - 14岁（aOR = 3.53，95%CI 3.03 - 4.11，P<0.001）]以及未使用蚊帐者（aOR = 1.49，95%CI 1.29 - 1.72，P<0.001）感染疟疾的几率更高。来自社会经济地位低的家庭的个体（aOR = 1.40，95%CI 1.16 - 1.69，P<0.001），或居住在窗户敞开（aOR = 1.24，95%CI 1.06 - 1.45，P<0.001）和/或墙上有洞的房屋中的个体（aOR = 1.43，95%CI 1.14 - 1.81，P<0.001）感染几率也更高。
疟疾感染率在各地区和村庄之间差异很大，男性、学童、未使用蚊帐者以及社会经济地位低或居住在窗户敞开和/或墙上有洞的房屋中的个体感染几率更高。应针对已确定的弱势群体和热点地区采取具体干预措施，以减轻疾病负担，并支持坦桑尼亚正在进行的疟疾消除工作。
