在加蓬一个疟疾监测哨点，新冠疫情开始前后的医院就诊情况、疟疾流行率以及使用抗疟药物的自我药疗情况。

Hospital attendance, malaria prevalence and self-medication with an antimalarial drug before and after the start of COVID-19 pandemic in a sentinel site for malaria surveillance in Gabon.

作者信息

Mawili-Mboumba Denise Patricia, Batchy Ognagosso Fanny Bertrande, M'Bondoukwé Noé Patrick, Ndong Ngomo Jacques Mari, Moutombi Ditombi Bridy Chesly, Agbanrin Ahmed Adissa, Nymane Tatiana, Pongui Ngondza Bedrich, Moutongo Mouandza Reinne, Mihindou Coella Joyce, Mabika Moussavou Dimitri Ardin, Mbang Nguema Ornella Anaïse, Bouyou-Akotet Marielle Karine

机构信息

Department of Parasitology-Mycology and Tropical Medicine, Université Des Sciences de La Santé de Libreville, BP 4009, Libreville, Gabon.

Operational and Clinical Research Unit, Regional Hospital Estuaire Melen, Libreville, Gabon.

出版信息

Malar J. 2025 Jan 25;24(1):28. doi: 10.1186/s12936-025-05272-2.

DOI:10.1186/s12936-025-05272-2

PMID:39863850

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11762114/

Abstract

BACKGROUND

The negative impact of COVID-19 pandemic on healthcare service utilization has been reported in several countries. In Gabon, data on the preparedness for future pandemic are lacking. The aim of the present study was to assess the trends of hospital attendance, malaria and self-medication prevalences as well as ITN use before and during Covid-19 first epidemic waves in a paediatric wards of a sentinel site for malaria surveillance, in Libreville, Gabon.

METHODS

This was a retrospective descriptive and hospital-based survey which was conducted at the Regional Hospital of Melen Estuaire (RHME). Census of files of patients below 18 years of age attending for fever management with a result of malaria biological diagnosis from January 2018 to December 2022 was conducted. Comparison of the prevalence of microscopic malaria, ITN use, self-medication and the fever duration prior the screening before and after year 2020 was performed using bivariate and multivariate analysis.

RESULTS

Overall, 14428 febrile participants were screened for malaria. A 15% increase in the number of febrile patients was observed between 2019 and 2020 while this rate was above 100% in 2021 and 2022. The frequency of self-medication significantly doubled in 2020 and 2021 compared to the pre-COVID-19 period (p < 0.01). Previous self-medication was more common during the COVID-19 period compared to the COVID-19 one (aOR = 2.15 [1.91-2.42]) (p < 0.01). Among the 7259 (51.2%) patients screened after 3 days of fever onset, self-anti-malarial treatment was reported for 17.5% of them in 2019 and for more than 30% of them from 2020: 33.3% in 2020, 35.0% in 2021 and 32.3% in 2022 (p < 0.01). The median of fever duration was significantly higher in the group of participants with a previous self-medication (p < 0.01). Positive blood smears frequency was higher in the COVID-19 period (35.6%; n = 3876/10868) compared to the pre-COVID-19 period (23.6%) (OR = 1.79[1.59-2.02], (p < 0.01).

CONCLUSION

Malaria prevalence and care-seeking behaviours for fever management in children significantly changed during the COVID-19 epidemic phase and subsequent years in the main malaria sentinel surveillance site of Gabon.

摘要

背景

在多个国家都报道了新冠疫情对医疗服务利用的负面影响。在加蓬，缺乏关于未来疫情防范的数据。本研究的目的是评估在加蓬利伯维尔一个疟疾监测哨点的儿科病房，在新冠疫情第一波流行之前和期间，医院就诊、疟疾和自我药疗患病率以及驱虫蚊帐使用情况的趋势。

方法

这是一项基于医院的回顾性描述性调查，在梅伦河口地区医院（RHME）进行。对2018年1月至2022年12月因发热管理就诊且疟疾生物学诊断结果为阳性的18岁以下患者的病历进行普查。使用双变量和多变量分析比较2020年前后显微镜下疟疾患病率、驱虫蚊帐使用情况、自我药疗情况以及筛查前的发热持续时间。

结果

总体而言，对14428名发热参与者进行了疟疾筛查。2019年至2020年期间发热患者数量增加了15%，而2021年和2022年这一增长率超过100%。与新冠疫情前相比，2020年和2021年自我药疗频率显著翻倍（p < 0.01）。与新冠疫情期间相比，新冠疫情前自我药疗更为常见（调整后比值比 = 2.15 [1.91 - 2.42]）（p < 0.01）。在发热发作3天后接受筛查并确诊的7259名（51.2%）患者中，2019年有17.5%的患者报告进行了自我抗疟治疗，2020年及以后超过30%：2020年为33.3%，2021年为35.0%，2022年为32.3%（p < 0.01）。自我药疗组的发热持续时间中位数显著更高（p < 0.01）。与新冠疫情前相比，新冠疫情期间血涂片阳性频率更高（35.6%；n = 3876/10868）（23.6%）（比值比 = 1.79[1.59 - 2.02]，（p < 0.01）。