Plasmodium falciparum malaria parasitaemia among indigenous Batwa and non-indigenous communities of Kanungu district, Uganda

Malaria Journal

Research

Sabastian Twesigomwe¹  Shuaib Lwasa²  Blánaid Donnelly³  Lea Berrang-Ford³  Nancy A. Ross³  Jolène Labbé³  Sherilee L. Harper⁴  Didacus B. Namanya⁵  Pascal Michel⁶  Manisha Kulkarni⁷ 

[1] Batwa Development Program, Buhoma, Kanungu District, Uganda;Department of Geography, Geoinformatics and Climatic Sciences, School of Forestry, Environmental and Geographical Sciences, CAES, Makerere University, P.O Box 7062, Kampala, Uganda;Department of Geography, McGill University, Burnside Hall Building, 805 Sherbrooke St West, H3A 0B9, Montreal, QC, Canada;Department of Population Medicine, Ontario Veterinary College, University of Guelph, N1G 2W1, Guelph, ON, Canada;Ministry of Health, P.O Box 7272, Plot 6 Lourdel Rd, Kampala, Uganda;Office of the Chief Science Officer, Public Health Agency of Canada, 130 Colonnade Road, K1A 0K9, Ottawa, ON, Canada;School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, 600 Peter Morand Cres., 301E, K1H 8M5, Ottawa, ON, Canada;

关键词: Indigenous health;    Batwa;    Malaria prevalence;    Malaria risk factors;    Livestock;    Zooprophylaxis;    Uganda;   

DOI  :  10.1186/s12936-016-1299-1

 received in 2015-08-25, accepted in 2016-04-18,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThe indigenous Batwa of southwestern Uganda are among the most highly impoverished populations in Uganda, yet there is negligible research on the prevalence of malaria in this population. Plasmodium falciparum malaria parasitaemia prevalence was estimated in an indigenous Batwa and a non-indigenous neighbouring population, and an exploration of modifiable risk factors was carried out to identify potential entry points for intervention. Additionally, evidence of zooprophylaxis was assessed, hypothesizing that livestock ownership may play a role in malaria risk.MethodsTwo cross-sectional surveys of Batwa and non-Batwa communities were carried out in Kanungu District, Uganda in July 2013 and April 2014 based on a census of adult Batwa and a two-stage systematic random sample of adult non-Batwa in ten Local Councils where Batwa settlements are located. A community-based questionnaire and antigen rapid diagnostic test for P. falciparum were carried out in the cross-sectional health surveys. A multivariable logistic regression model was built to identify risk factors associated with positive malaria diagnostic test. A subset analysis of livestock owners tested for zooprophylaxis.ResultsBatwa experienced higher prevalence of malaria parasitaemia than non-Batwa (9.35 versus 4.45 %, respectively) with over twice the odds of infection (OR 2.21, 95 % CI 1.23–3.98). Extreme poverty (OR 1.96, 95 % CI 0.98–3.94) and having an iron sheet roof (OR 2.54, 95 % CI 0.96–6.72) increased the odds of infection in both Batwa and non-Batwa. Controlling for ethnicity, wealth, and bed net ownership, keeping animals inside the home at night decreased the odds of parasitaemia among livestock owners (OR 0.29, 95 % CI 0.09–0.94).ConclusionA health disparity exists between indigenous Batwa and non-indigenous community members with Batwa having higher prevalence of malaria relative to non-Batwa. Poverty was associated with increased odds of malaria infection for both groups. Findings suggest that open eaves and gaps in housing materials associated with iron sheet roofing represent a modifiable risk factor for malaria, and may facilitate mosquito house entry; larger sample sizes will be required to confirm this finding. Evidence for possible zooprophylaxis was observed among livestock owners in this population for those who sheltered animals inside the home at night.

【 授权许可】

CC BY   
© Donnelly et al. 2016