背景:疟疾仍然是撒哈拉以南非洲(SSA)的重大公共卫生挑战,特别影响五岁以下儿童(UN5)。尽管全球努力控制这种疾病,它在高风险非洲国家的流行率仍然令人担忧,有大量发病率和死亡率的记录。理解多重童年的关联,母性,以及疟疾流行的家庭因素,特别是在脆弱的年轻人中,对于有效的干预策略至关重要。
目的:本研究检查了选定的SSA高危国家的UN5儿童中疟疾的患病率,并分析了其与各种儿童的关系,母性,和家庭因素。
方法:分析了2010年至2023年疟疾指标调查(MIS)的数据。分析中考虑了来自撒哈拉以南非洲(SSA)七个国家的35,624名UN5儿童的加权样本,这些儿童的疟疾流行率很高。描述性统计和改良的Poisson回归分析用于评估多因素与疟疾患病率的关联。Stata版本15软件用于分析数据,并将统计显著性设定为5%显著性水平。
结果:研究人群中疟疾的总体合并患病率为26.2%,观察到特定国家的实质性差异。就儿童因素而言,儿童年龄与疟疾患病率显著相关(APR=1.010,95%CI:1.007-1.012)。受教育程度较高的母亲的子女(高等教育的APR=0.586,95%CI:0.425-0.806)和怀孕期间Fansidar摄取(APR=0.731,95%CI:0.666-0.802)与较低的疟疾风险相关。与贫困家庭相比,中等财富家庭(APR=0.783,95%CI:0.706-0.869)和富裕家庭(APR=0.499,95%CI:0.426-0.584)的儿童的疟疾患病率要低得多。此外,与城市居民相比,农村居民与更高的疟疾风险相关(APR=1.545,95%CI:1.255-1.903).
结论:该研究强调了在高危SSA国家的五岁以下(UN5)儿童中疟疾的明显流行,受母亲教育等因素的影响显著,Fansidar在怀孕期间的摄取,社会经济地位,和居住权。这些发现强调了有针对性的疟疾预防战略的重要性,这些战略解决了这些关键决定因素,以有效减轻这一弱势群体的疟疾负担。
BACKGROUND: Malaria remains a significant public health challenge in Sub-Saharan Africa (SSA), particularly affecting under-five (UN5) children. Despite global efforts to control the disease, its prevalence in high-risk African countries continues to be alarming, with records of substantial morbidity and mortality rates. Understanding the association of multiple childhood, maternal, and household factors with malaria prevalence, especially among vulnerable young populations, is crucial for effective intervention strategies.
OBJECTIVE: This study examines the prevalence of malaria among UN5 children in selected high-risk SSA countries and analyzes its association with various childhood, maternal, and household factors.
METHODS: Data from the Malaria Indicator Surveys (MIS) spanning from 2010 to 2023 were analyzed. A weighted sample of 35,624 UN5 children from seven countries in sub-Saharan Africa (SSA) known for high malaria prevalence was considered in the analyses. Descriptive statistics and modified Poisson regression analysis were used to assess the association of multiple factors with malaria prevalence. Stata version 15 software was used in analyzing the data and statistical significance was set at a 5% significance level.
RESULTS: The overall pooled prevalence of malaria among the studied population was 26.2%, with substantial country-specific variations observed. In terms of child factors, a child\'s age was significantly associated with malaria prevalence (APR = 1.010, 95% CI: 1.007-1.012). Children of mothers with higher education levels (APR for higher education = 0.586, 95% CI: 0.425-0.806) and Fansidar uptake during pregnancy (APR = 0.731, 95% CI: 0.666-0.802) were associated with lower malaria risk. Children from middle-wealth (APR = 0.783, 95% CI: 0.706-0.869) and rich (APR = 0.499, 95% CI: 0.426-0.584) households had considerably lower malaria prevalence compared to those from poor households. Additionally, rural residency was associated with a higher risk of malaria compared to urban residency (APR = 1.545, 95% CI: 1.255-1.903).
CONCLUSIONS: The study highlights a notable malaria prevalence among under-five (UN5) children in high-risk SSA countries, influenced significantly by factors such as maternal education, Fansidar uptake during pregnancy, socioeconomic status, and residency. These findings underscore the importance of targeted malaria prevention strategies that address these key determinants to effectively reduce the malaria burden in this vulnerable population.