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乌干达中部卡永加区卡永加地区转诊医院五岁以下儿童疟疾复发的相关因素。

Factors associated with recurrent malaria episodes among children under five at Kayunga Regional Referral Hospital in Kayunga District, Central Uganda.

作者信息

Modi Derick, Musinguzi Marvin, Pita Patricia, Kigongo Eustes, Kabunga Amir, Kayizzi Julius, Kasaija Deo, Khanakwa Voni Alice, Alyao Oscar Simon, Lubangakene Julius, Murungi Tom, Oneka Christopher Okullo, Opollo Marc Sam

机构信息

Department of Community Health, Faculty of Public Health, Lira University, Lira City, Uganda.

Department of Midwifery, Faculty of Nursing and Midwifery, Lira University, Lira City, Uganda.

出版信息

PLoS One. 2025 Jun 12;20(6):e0320112. doi: 10.1371/journal.pone.0320112. eCollection 2025.

Abstract

BACKGROUND

Malaria poses a substantial global challenge and continues to be a major cause of mortality and morbidity in numerous developing nations. Children under the age of five in low- and middle-income countries such as Uganda are the most affected. However, there remains a deficiency in knowledge regarding recurrent malaria episodes in Uganda. We determined the prevalence and factors associated with recurrent malaria episodes among children under five at Kayunga Regional Referral Hospital.

METHODOLOGY

This was a cross-sectional study conducted among children under five at Kayunga Regional Referral Hospital in central Uganda. The data was collected among 250 consecutively sampled participants who were caring for children under five. Data was collected using a researcher-administered questionnaire and analyzed at univariate, bivariate, and multivariate levels.

RESULTS

A total of 250 participants participated in the study with a response rate of 98.45%. The prevalence of recurrent malaria episodes was 84% (210). The factors significantly associated with recurrent malaria episodes were; children from houses that were annually sprayed (aOR; 8.93, 95%CI,2.11-37.81), children from houses that were not sprayed (aOR; 3.80,95%CI,1.27-9.41, p = 0.017), children who were treated with quinine antimalarial in the previous infection (aOR, 0.28, 95%CI,0.12-0.65) and children who were residing in a house whose windows were closed at 7-8 pm (aOR, 8.31, 95%CI, 2.21-10.27).

CONCLUSION

The recurrence of malaria episodes among children under five is significantly high, suggesting the possibility of malaria resistance. Importantly, quinine remains a robust alternative treatment for complicated malaria, owing to its significant efficacy against malaria parasites in regions of moderate to high transmission rates. Malaria prevention programs should consider biannual indoor residual spraying in high malaria transmission areas using vector-susceptible insecticides.

摘要

背景

疟疾是一项重大的全球挑战,在许多发展中国家仍是导致死亡和发病的主要原因。乌干达等低收入和中等收入国家五岁以下儿童受影响最为严重。然而,乌干达关于疟疾复发的知识仍然不足。我们确定了卡永加地区转诊医院五岁以下儿童疟疾复发的患病率及相关因素。

方法

这是一项在乌干达中部卡永加地区转诊医院对五岁以下儿童开展的横断面研究。数据收集于250名连续抽样的五岁以下儿童的照料者。通过研究人员发放的问卷收集数据,并在单变量、双变量和多变量层面进行分析。

结果

共有250名参与者参与了研究,应答率为98.45%。疟疾复发的患病率为84%(210例)。与疟疾复发显著相关的因素有:来自每年进行室内喷洒的家庭的儿童(调整后比值比;8.93,95%置信区间,2.11 - 37.81),来自未进行室内喷洒的家庭的儿童(调整后比值比;3.80,95%置信区间,1.27 - 9.41,p = 0 .017),上次感染时接受过奎宁抗疟治疗的儿童(调整后比值比,0.28,95%置信区间,0.12 - 0.65)以及晚上7 - 8点窗户关闭的家庭中的儿童(调整后比值比,8.31,95%置信区间,2.21 - 10.27)。

结论

五岁以下儿童疟疾复发率显著偏高,提示可能存在疟疾耐药性。重要的是,由于奎宁对中高传播率地区的疟原虫具有显著疗效,它仍是治疗复杂疟疾的有效替代药物。疟疾预防项目应考虑在疟疾高传播地区使用对媒介敏感的杀虫剂进行一年两次的室内滞留喷洒。

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