A cohort study to identify risk factors for Plasmodium falciparum infection in Burkinabe children: implications for other high burden high impact countries

Malaria Journal

Z. Amidou Ouedraogo¹  Alphonse Ouedraogo¹  Alfred B. Tiono¹  Malik Lankouande¹  Kobié Hyacinthe Toe¹  Amidou Diarra¹  W. Moussa Guelbeogo¹  N’Fale Sagnon¹  Jean Baptiste Yaro²  Antoine Sanou³  Steven W. Lindsay⁴  Efundem Agboraw⁵  Anne L. Wilson⁵  Eve Worrall⁵  Hilary Ranson⁵ 

[1] Centre National de Recherche et de Formation sur le Paludisme, Ouagadougou, Burkina Faso;Centre National de Recherche et de Formation sur le Paludisme, Ouagadougou, Burkina Faso;Department of Biosciences, Durham University, Durham, UK;Centre National de Recherche et de Formation sur le Paludisme, Ouagadougou, Burkina Faso;Institute of Biodiversity Animal Health & Comparative Medicine, Glasgow University, Glasgow, UK;Department of Biosciences, Durham University, Durham, UK;Department of Vector Biology, Liverpool School of Tropical Medicine, Liverpool, UK;

关键词: Malaria;    Epidemiology;    Cohort study;    Burkina faso;    Vector control;    Insecticide resistance;   

DOI  :  10.1186/s12936-020-03443-x

来源: Springer

【 摘 要 】

BackgroundProgress in controlling malaria has stalled in recent years. Today the malaria burden is increasingly concentrated in a few countries, including Burkina Faso, where malaria is not declining. A cohort study was conducted to identify risk factors for malaria infection in children in southwest Burkina Faso, an area with high insecticide-treated net (ITN) coverage and insecticide-resistant vectors.MethodsIncidence of Plasmodium falciparum infection was measured in 252 children aged 5 to 15 years, using active and passive detection, during the 2017 transmission season, following clearance of infection. Demographic, socio-economic, environmental, and entomological risk factors, including use of ITNs and insecticide resistance were monitored.ResultsDuring the six-month follow-up period, the overall incidence of P. falciparum infection was 2.78 episodes per child (95% CI = 2.66–2.91) by microscopy, and 3.11 (95% CI = 2.95–3.28) by polymerase chain reaction (PCR). The entomological inoculation rate (EIR) was 80.4 infective bites per child over the six-month malaria transmission season. At baseline, 80.6% of children were reported as sleeping under an ITN the previous night, although at the last survey, 23.3% of nets were in poor condition and considered no longer protective. No association was found between the rate of P. falciparum infection and either EIR (incidence rate ratio (IRR): 1.00, 95% CI: 1.00–1.00, p = 0.08) or mortality in WHO tube tests when vectors were exposed to 0.05% deltamethrin (IRR: 1.05, 95% CI: 0.73–1.50, p = 0.79). Travel history (IRR: 1.52, 95% CI: 1.45–1.59, p < 0.001) and higher socio-economic status were associated with an increased risk of P. falciparum infection (IRR: 1.05, 95% CI: 1.00–1.11, p = 0.04).ConclusionsIncidence of P. falciparum infection remains overwhelmingly high in the study area. The study findings suggest that because of the exceptionally high levels of malaria transmission in the study area, malaria elimination cannot be achieved solely by mass deployment of ITNs and additional control measures are needed.

【 授权许可】

CC BY