Malaria parasite carriage and risk determinants in a rural population: a malariometric survey in Rwanda

Malaria Journal

Research

Michèle van Vugt¹  Martin P Grobusch¹  Fredrick Kateera²  Petra F Mens³  Leon Mutesa⁴  Emmanuel Hakizimana⁵  Parfait Karinda⁶  Chantal M Ingabire⁶  Liberata Muragijemariya⁷ 

[1] Centre of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Centre, Meibergdreef 9, 1100 DE, Amsterdam, The Netherlands;Centre of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Centre, Meibergdreef 9, 1100 DE, Amsterdam, The Netherlands;Medical Research Centre Division, Rwanda Biomedical Centre, PO Box 7162, Kigali, Rwanda;Centre of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Centre, Meibergdreef 9, 1100 DE, Amsterdam, The Netherlands;Royal Tropical Institute/Koninklijk Instituut voor de Tropen, KIT Biomedical Research, Meibergdreef 39, 1105 AZ, Amsterdam, The Netherlands;College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda;Malaria & Other Parasitic Diseases Division, Rwanda Biomedical Centre, Kigali, Rwanda;Medical Research Centre Division, Rwanda Biomedical Centre, PO Box 7162, Kigali, Rwanda;Ruhuha Health Centre, Ruhuha Sector, Bugesera, Rwanda;

关键词: Malaria;    Prevalence;    Risk factors;    LLINs;    IRS;    Socio-economic status;    Rwanda;   

DOI  :  10.1186/s12936-014-0534-x

 received in 2014-10-11, accepted in 2014-12-27,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundBased on routine health facility case data, Rwanda has achieved a significant malaria burden reduction in the past ten years. However, community-based malaria parasitaemia burden and reasons for continued residual infections, despite a high coverage of control interventions, have yet to be characterized. Measurement of malaria parasitaemia rates and evaluation of associated risk factors among asymptomatic household members in a rural community in Rwanda were conducted.MethodsA malariometric household survey was conducted between June and November 2013, involving 12,965 persons living in 3,989 households located in 35 villages in a sector in eastern Rwanda. Screening for malaria parasite carriage and collection of demographic, socio-economic, house structural features, and prior fever management data, were performed. Logistic regression models with adjustment for within- and between-households clustering were used to assess malaria parasitaemia risk determinants.ResultsOverall, malaria parasitaemia was found in 652 (5%) individuals, with 518 (13%) of households having at least one parasitaemic member. High malaria parasite carriage risk was associated with being male, child or adolescent (age group 4–15), reported history of fever and living in a household with multiple occupants. A malaria parasite carriage risk-protective effect was associated with living in households of, higher socio-economic status, where the head of household was educated and where the house floor or walls were made of cement/bricks rather than mud/earth/wood materials. Parasitaemia cases were found to significantly cluster in the Gikundamvura area that neighbours marshlands.ConclusionOverall, Ruhuha Sector can be classified as hypo-endemic, albeit with a particular ‘cell of villages’ posing a higher risk for malaria parasitaemia than others. Efforts to further reduce transmission and eventually eliminate malaria locally should focus on investments in programmes that improve house structure features (that limit indoor malaria transmission), making insecticide-treated bed nets and indoor residual spraying implementation more effective.

【 授权许可】

CC BY   
© Kateera et al.; licensee Biomed Central. 2015