Environmental risk factors and exposure to the zoonotic malaria parasite Plasmodium knowlesi across northern Sabah, Malaysia: a population-based cross-sectional survey

Autor: Thomas A. Hall, Tock H. Chua, Lou S. Herman, Kimberly M. Fornace, Catriona Patterson, Jonathan Cox, Timothy William, Sylvia Daim, Kevin K. A. Tetteh, Tommy R Abidin, Lynn Grignard, Matthew J. Grigg, Nicholas M. Anstey, Chris Drakeley, Paddy M Brock
Rok vydání: 2018
Předmět:
Male
Health (social science)
Cross-sectional study
Range (biology)
Plasmodium vivax
Medicine (miscellaneous)
010501 environmental sciences
01 natural sciences
law.invention
0302 clinical medicine
law
Risk Factors
Seroepidemiologic Studies
Zoonoses
Prevalence
030212 general & internal medicine
Child
Asymptomatic Infections
lcsh:Environmental sciences
lcsh:GE1-350
Aged
80 and over
biology
Health Policy
Incidence (epidemiology)
Middle Aged
Transmission (mechanics)
Plasmodium knowlesi
Child
Preschool
Female
Adult
Adolescent
03 medical and health sciences
Young Adult
Environmental health
parasitic diseases
medicine
Animals
Humans
0105 earth and related environmental sciences
Aged
Public Health
Environmental and Occupational Health
Malaysia
Infant
Plasmodium falciparum
biology.organism_classification
medicine.disease
Malaria
Cross-Sectional Studies
Zdroj: The Lancet Planetary Health, Vol 3, Iss 4, Pp e179-e186 (2019)
ISSN: 2542-5196
Popis: Summary Background Land use changes disrupt ecosystems, altering the transmission of vector-borne diseases. These changes have been associated with increasing incidence of zoonotic malaria caused by Plasmodium knowlesi; however, the population-level distributions of infection and exposure remain unknown. We aimed to measure prevalence of serological exposure to P knowlesi and assess associated risk factors. Methods We did an environmentally stratified, population-based, cross-sectional survey across households in the Kudat, Kota Marudu, Pitas, and Ranau districts in northern Sabah, Malaysia, encompassing a range of ecologies. Using blood samples, the transmission intensity of P knowlesi and other malaria species was measured by specific antibody prevalence and infection detected using molecular methods. Proportions and configurations of land types were extracted from maps derived from satellite images; a data-mining approach was used to select variables. A Bayesian hierarchical model for P knowlesi seropositivity was developed, incorporating questionnaire data about individual and household-level risk factors with selected landscape factors. Findings Between Sept 17, 2015, and Dec 12, 2015, 10 100 individuals with a median age of 25 years (range 3 months to 105 years) were sampled from 2849 households in 180 villages. 5·1% (95% CI 4·8–5·4) were seropositive for P knowlesi, and marked historical decreases were observed in the transmission of Plasmodium falciparum and Plasmodium vivax. Nine Plasmodium spp infections were detected. Age, male sex, contact with macaques, forest use, and raised house construction were positively associated with P knowlesi exposure, whereas residing at higher geographical elevations and use of insecticide were protective. Agricultural and forest variables, such as proportions and fragmentation of land cover types, predicted exposure at different spatial scales from households. Interpretation Although few infections were detected, P knowlesi exposure was observed in all demographic groups and was associated with occupational factors. Results suggest that agricultural expansion and forest fragmentation affect P knowlesi exposure, supporting linkages between land use change and P knowlesi transmission. Funding UK Medical Research Council, Natural Environment Research Council, Economic and Social Research Council, and Biotechnology and Biosciences Research Council.
Databáze: OpenAIRE
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