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控制干预措施对马里普通人群疟疾发病率的影响。

Impact of Control Interventions on Malaria Incidence in the General Population of Mali.

作者信息

Cissoko Mady, Sagara Issaka, Guindo Abdoulaye, Maiga Mahamane, Dembélé Pascal, Bationo Cedric S, Dieng Sokhna, Diarra Issa, Katilé Abdoulaye, Traoré Diahara, Dessay Nadine, Gaudart Jean

机构信息

Malaria Research and Training Centre Ogobara K. Doumbo (MRTC-OKD), FMOS-FAPH, Mali-NIAID-ICER, Université des Sciences, des Techniques et des Technologies de Bamako, 1805, Bamako, Mali.

Aix Marseille Univ, INSERM, IRD, ISSPAM, UM1252, 13005, Marseille, France.

出版信息

J Epidemiol Glob Health. 2025 Mar 12;15(1):40. doi: 10.1007/s44197-025-00381-2.

DOI:10.1007/s44197-025-00381-2
PMID:40072686
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11903980/
Abstract

BACKGROUND

The increase in malaria incidence and the reduction of funding for malaria control have highlighted the need to step up efforts in the fight against malaria in Mali. To further refine the malaria control strategy implemented in the country, this study aimed to evaluate the impact of control interventions at the health district level on malaria incidence in the general population.

METHOD

Malaria, rainfall, and intervention data were collected for the 75 health districts of Mali for the period from April 2017 to March 2022. The impact of the different control interventions on malaria incidence in the general population was assessed at the health district level with a Generalized Additive Mixed Model considering rainfall.

RESULTS

Although coverage rates varied widely between health districts, most interventions showed an improvement in coverage over the study period. Two interventions had a small impact on incidence: long-lasting insecticidal net mass distribution (LLIN), with a reduction rate of 2.2 ‰ for an adjusted coverage rate from 30.0 to 79.0% (odds ratio (OR): 0.998; 95% confidence interval (CI) 0.997-0.999), and seasonal malaria chemoprevention (SMC), with a reduction rate of 1.9 ‰ for an adjusted coverage rate from 30.0 to 80.0% (OR: 0.9979; 95% CI 0.996-0.998).

CONCLUSION

The analysis found a small impact of LLIN and SMC on malaria incidence at the district level. Malaria control should be reinforced by improving coverage and utilization rates in the general population and in the most vulnerable groups and by deploying larger numbers of community health workers where needed.

摘要

背景

疟疾发病率上升以及疟疾防控资金减少凸显了在马里加大抗击疟疾力度的必要性。为进一步完善该国实施的疟疾防控策略，本研究旨在评估卫生区层面的防控干预措施对普通人群疟疾发病率的影响。

方法

收集了2017年4月至2022年3月期间马里75个卫生区的疟疾、降雨和干预数据。在考虑降雨因素的情况下，使用广义相加混合模型在卫生区层面评估不同防控干预措施对普通人群疟疾发病率的影响。

结果

尽管各卫生区的覆盖率差异很大，但在研究期间，大多数干预措施的覆盖率都有所提高。有两项干预措施对发病率有较小影响：长效驱虫蚊帐大规模分发（LLIN），调整后的覆盖率从30.0%提高到79.0%时，发病率降低率为2.2‰（优势比（OR）：0.998；95%置信区间（CI）0.997 - 0.999）；季节性疟疾化学预防（SMC），调整后的覆盖率从30.0%提高到80.0%时，发病率降低率为1.9‰（OR：0.9979；95% CI 0.996 - 0.998）。

结论

分析发现，长效驱虫蚊帐和季节性疟疾化学预防在地区层面上对疟疾发病率影响较小。应通过提高普通人群和最脆弱群体的覆盖率及使用率，并在需要的地方部署更多社区卫生工作者来加强疟疾防控。

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