Weyou Zidedine Nematchoua, Djieyep Felicite Djemna, Teh Rene Ning, Lontsi-Demano Michel, Dieng Cheikh Cambel, Bamou Roland, Lo Eugenia, Kimbi Helen Kuokuo, Sumbele Irene Ule Ngole
Department of Animal Biology and Conservation (ABC), Faculty of Science, University of Buea, Buea, Cameroon.
Department of AgroEcoHealth, International Institute of Tropical Agriculture (IITA), Cotonou, Benin.
Front Trop Dis. 2024;5. doi: 10.3389/fitd.2024.1508750. Epub 2024 Dec 2.
Refugees are vulnerable populations especially in malaria endemic areas where the disease claims many lives and constitutes an emerging challenge for humanitarian response. This study assessed how the influx and settlement of Central African Republic (CAR) refugees influences malaria burden in the Gado-Badzere refugee camp, Eastern Cameroon.
A cross-sectional malariometric survey was conducted between November 2022 and October 2023 in 324 households comprising 1,304 individuals aged 1 month and above. Malaria parasite burden was determined using rapid diagnostic tests (RDTs) and Giemsa-stained microscopy. Demographic characteristics, malaria risk factors, treatment-seeking behaviors and costs to cure malaria were assessed using semi-structured questionnaires.
Of the 1,304 participants, 525 (40.3%) were malaria parasite positive with moderate geometric mean parasite density (GMPD) of 1100 parasites/μl of blood. was the main species (99.8%), with mixed infections (0.2%). Insecticide treated net (ITN) ownership was 53.7%, but its utilization was significantly low (22.4%) (P < 0.001). Reason for no ITN ownership was net damaged (74.7%). Net insufficiency (77.8%) accounted for non-frequent ITN use. Mean expenditure to treat malaria in the hospital was higher (USD 13.64 ± 8.67) than auto-medication (USD 1.13 ± 1.18). Significantly, malaria parasite prevalence and risk were higher for 0-5 years age (43.7%, OR = 1; P = 0.02), residents of sector 8 (49.2%, OR = 2.53; P < 0.001) of the camp, non-frequent ITN users (41.7%, OR = 2.08; P < 0.001), people living around stagnant water (44.4%, OR = 1.55; P < 0.001) and during the rainy season (43.5%, OR = 1.31; P = 0.02). The GMPD/μl was significantly higher in the 0-5 years age group (1456, P < 0.0001), inhabitants of sector 9 (1626, P = 0.04) and participants living around stagnant water (2097, P = 0.01).
The malaria burden in CAR refugees may represent the reservoir for malaria transmission, especially with the circulation of . The improper use of ITNs could be ameliorated through sensitization. Seasonal chemoprevention mainly during the rainy season and Indoor Residual Spraying (IRS) might be implemented for effective malaria control in refugee settings.
难民是弱势群体，尤其是在疟疾流行地区，该病夺走了许多人的生命，对人道主义应对构成了新的挑战。本研究评估了中非共和国（CAR）难民的涌入和定居如何影响喀麦隆东部加多加泽尔难民营的疟疾负担。
2022年11月至2023年10月期间，对324户家庭（共1304名1个月及以上的个体）进行了横断面疟疾测量调查。使用快速诊断测试（RDT）和吉姆萨染色显微镜检查来确定疟原虫负担。使用半结构化问卷评估人口统计学特征、疟疾危险因素、寻求治疗行为和治疗疟疾的费用。
在1304名参与者中，525人（40.3%）疟原虫呈阳性，几何平均寄生虫密度（GMPD）为每微升血液1100个寄生虫，为主要种类（99.8%），混合感染占0.2%。经杀虫剂处理的蚊帐（ITN）拥有率为53.7%，但其使用率极低（22.4%）（P<0.001）。没有ITN的原因是蚊帐损坏（74.7%）。蚊帐不足（77.8%）导致ITN使用不频繁。在医院治疗疟疾的平均费用（13.64美元±8.67美元）高于自我用药（1.13美元±1.18美元）。值得注意的是，0至5岁年龄组（43.7%，OR=1；P=0.02）、难民营8区居民（49.2%，OR=2.53；P<0.001）、不常使用ITN的人（41.7%，OR=2.08；P<0.001）、生活在积水附近的人（44.4%，OR=1.55；P<0.001）以及雨季期间（43.5%，OR=1.31；P=0.02）的疟疾寄生虫患病率和风险更高。0至5岁年龄组每微升的GMPD显著更高（1456，P<0.0001），9区居民（1626，P=0.04）以及生活在积水附近的参与者（2097，P=0.01）也是如此。
中非共和国难民中的疟疾负担可能是疟疾传播的源头，尤其是随着的传播。通过宣传可以改善ITN的不当使用情况。在难民环境中有效控制疟疾可实施主要在雨季的季节性化学预防和室内滞留喷洒（IRS）。
