The potential of pregnant women as a sentinel population for malaria surveillance.

Autor: Brunner NC; Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002, Basel, Switzerland.; University of Basel, Petersplatz 1, 4003, Basel, Switzerland., Chacky F; National Malaria Control Programme, P.O. Box 9083, Dar es Salaam, United Republic of Tanzania.; Ministry of Health, Community Development, Gender, Elderly and Children, Building No. 11, P. O. Box 743, 40478, Dodoma, United Republic of Tanzania., Mandike R; National Malaria Control Programme, P.O. Box 9083, Dar es Salaam, United Republic of Tanzania.; Ministry of Health, Community Development, Gender, Elderly and Children, Building No. 11, P. O. Box 743, 40478, Dodoma, United Republic of Tanzania., Mohamed A; National Malaria Control Programme, P.O. Box 9083, Dar es Salaam, United Republic of Tanzania.; Ministry of Health, Community Development, Gender, Elderly and Children, Building No. 11, P. O. Box 743, 40478, Dodoma, United Republic of Tanzania., Runge M; Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002, Basel, Switzerland.; University of Basel, Petersplatz 1, 4003, Basel, Switzerland., Thawer SG; Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002, Basel, Switzerland.; University of Basel, Petersplatz 1, 4003, Basel, Switzerland.; National Malaria Control Programme, P.O. Box 9083, Dar es Salaam, United Republic of Tanzania., Ross A; Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002, Basel, Switzerland.; University of Basel, Petersplatz 1, 4003, Basel, Switzerland., Vounatsou P; Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002, Basel, Switzerland.; University of Basel, Petersplatz 1, 4003, Basel, Switzerland., Lengeler C; Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002, Basel, Switzerland.; University of Basel, Petersplatz 1, 4003, Basel, Switzerland., Molteni F; Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002, Basel, Switzerland.; University of Basel, Petersplatz 1, 4003, Basel, Switzerland.; National Malaria Control Programme, P.O. Box 9083, Dar es Salaam, United Republic of Tanzania., Hetzel MW; Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002, Basel, Switzerland. manuel.hetzel@swisstph.ch.; University of Basel, Petersplatz 1, 4003, Basel, Switzerland. manuel.hetzel@swisstph.ch.
Jazyk: angličtina
Zdroj: Malaria journal [Malar J] 2019 Nov 21; Vol. 18 (1), pp. 370. Date of Electronic Publication: 2019 Nov 21.
DOI: 10.1186/s12936-019-2999-0
Abstrakt: Background: With increasing spatial heterogeneity of malaria transmission and a shift of the disease burden towards older children and adults, pregnant women attending antenatal care (ANC) have been proposed as a pragmatic sentinel population for malaria surveillance. However, the representativeness of routine ANC malaria test-positivity and its relationship with prevalence in other population subgroups are yet to be investigated.
Methods: Monthly ANC malaria test-positivity data from all Tanzanian health facilities for January 2014 to May 2016 was compared to prevalence data from the School Malaria Parasitaemia Survey 2015, the Malaria Indicator Survey (MIS) 2015/16, the Malaria Atlas Project 2015, and a Bayesian model fitted to MIS data. Linear regression was used to describe the difference between malaria test-positivity in pregnant women and respective comparison groups as a function of ANC test-positivity and potential covariates.
Results: The relationship between ANC test-positivity and survey prevalence in children follows spatially and biologically meaningful patterns. However, the uncertainty of the relationship was substantial, particularly in areas with high or perennial transmission. In comparison, modelled data estimated higher prevalence in children at low transmission intensities and lower prevalence at higher transmission intensities.
Conclusions: Pregnant women attending ANC are a pragmatic sentinel population to assess heterogeneity and trends in malaria prevalence in Tanzania. Yet, since ANC malaria test-positivity cannot be used to directly predict the prevalence in other population subgroups, complementary community-level measurements remain highly relevant.
Databáze: MEDLINE
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