Disparities of Plasmodium falciparum infection, malaria-related morbidity and access to malaria prevention and treatment among school-aged children: a national cross-sectional survey in Côte d’Ivoire

Malaria Journal

Research

Jürg Utzinger¹  Penelope Vounatsou¹  Eveline Hürlimann²  Giovanna Raso²  Richard B Yapi³  Kigbafori D Silué⁴  Eliézer K N’Goran⁴  Serge-Brice Assi⁵  Gotianwa Soro⁶  Cinthia A Acka⁷  Agathe Fantodji⁸  Prisca B N’Dri⁹  Benjamin G Koudou^1,10  Clarisse A Houngbedji^1,11 

[1] Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland;University of Basel, Petersplatz 1, CH-4003, Basel, Switzerland;Département Environnement et Santé, Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, 01 BP 1303, Abidjan 01, Côte d’Ivoire;Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland;University of Basel, Petersplatz 1, CH-4003, Basel, Switzerland;Département Environnement et Santé, Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, 01 BP 1303, Abidjan 01, Côte d’Ivoire;Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland;University of Basel, Petersplatz 1, CH-4003, Basel, Switzerland;Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, 22 BP 522, Abidjan 22, Côte d’Ivoire;Département Environnement et Santé, Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, 01 BP 1303, Abidjan 01, Côte d’Ivoire;Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, 22 BP 522, Abidjan 22, Côte d’Ivoire;Institut Pierre Richet de Bouaké, Institut National de Santé Publique, BP 1500, Bouaké, Côte d’Ivoire;Programme National de Lutte contre le Paludisme, Ministère de la Santé et de la Lutte contre le Sida, BP V 4, Abidjan, Côte d’Ivoire;Programme National de Santé Scolaire et Universitaire, 01 BP 1725, Abidjan 01, Côte d’Ivoire;United Nations Children Funds, BP 1650, Bujumbura, Burundi;Unité de Formation et de Recherche Sciences de la Nature, Université Nangui Abrogoua, 02 BP 801, Abidjan 02, Côte d’Ivoire;Unité de Formation et de Recherche Sciences de la Nature, Université Nangui Abrogoua, 02 BP 801, Abidjan 02, Côte d’Ivoire;Département Environnement et Santé, Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, 01 BP 1303, Abidjan 01, Côte d’Ivoire;Unité de Formation et de Recherche Sciences de la Nature, Université Nangui Abrogoua, 02 BP 801, Abidjan 02, Côte d’Ivoire;Département Environnement et Santé, Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, 01 BP 1303, Abidjan 01, Côte d’Ivoire;Centre for Neglected Tropical Diseases, Liverpool School of Tropical Medicine, L3 5QA, Liverpool, UK;Unité de Formation et de Recherche Sciences de la Nature, Université Nangui Abrogoua, 02 BP 801, Abidjan 02, Côte d’Ivoire;Département Environnement et Santé, Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, 01 BP 1303, Abidjan 01, Côte d’Ivoire;Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland;University of Basel, Petersplatz 1, CH-4003, Basel, Switzerland;

关键词: Malaria;    Plasmodium falciparum;    School-aged children;    Self-reported morbidity;    Access to prevention and treatment;    Cross-sectional survey;    Microscopy;    Rapid diagnostic test;    Côte d’Ivoire;   

DOI  :  10.1186/1475-2875-14-7

 received in 2014-09-01, accepted in 2014-12-16,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundThere is limited knowledge on the malaria burden of school-aged children in Côte d’Ivoire. The aim of this study was to assess Plasmodium falciparum infection, malaria-related morbidity, use of preventive measures and treatment against malaria, and physical access to health structures among school-aged children across Côte d’Ivoire.MethodsA national, cross-sectional study was designed, consisting of clinical and parasitological examinations and interviews with schoolchildren. More than 5,000 children from 93 schools in Côte d’Ivoire were interviewed to determine household socioeconomic status, self-reported morbidity and means of malaria prevention and treatment. Finger-prick blood samples were collected and Plasmodium infection and parasitaemia determined using Giemsa-stained blood films and a rapid diagnostic test (RDT). Haemoglobin levels and body temperature were measured. Children were classified into wealth quintiles using household assets and principal components analysis (PCA). The concentration index was employed to determine significant trends of health variables according to wealth quintiles. Logistic and binomial negative regression analyses were done to investigate for associations between P. falciparum prevalence and parasitaemia and any health-related variable.ResultsThe prevalence of P. falciparum was 73.9% according to combined microscopy and RDT results with a geometric mean of parasitaemia among infected children of 499 parasites/μl of blood. Infection with P. falciparum was significantly associated with sex, socioeconomic status and study setting, while parasitaemia was associated with age. The rate of bed net use was low compared to the rate of bed net ownership. Preventive measures (bed net ownership, insecticide spray and the reported use of malaria treatment) were more frequently mentioned by children from wealthier households who were at lower risk of P. falciparum infection. Self-reported morbidity (headache) and clinical morbidity (anaemia) were more often reported by children from less wealthy households.ConclusionSeven out of ten school-aged children in Côte d’Ivoire are infected with P. falciparum and malaria-related morbidity is considerable. Furthermore, this study points out that bed net usage is quite low and there are important inequalities in preventive measures and treatment. These results can guide equity-oriented malaria control strategies in Côte d’Ivoire.

【 授权许可】

Unknown   
© Houngbedji et al.; licensee BioMed Central. 2015. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.