Fine-scale spatial and temporal variation of clinical malaria incidence and associated factors in children in rural Malawi: a longitudinal study

Autor: Martin P. Grobusch, Michèle van Vugt, Michael G. Chipeta, Steve Gowelo, Zinenani Truwah, Monicah M. Mburu, Robert S. McCann, Kamija S. Phiri, Alinune N. Kabaghe
Přispěvatelé: APH - Aging & Later Life, Graduate School, APH - Global Health, APH - Quality of Care, AII - Infectious diseases, Infectious diseases, APH - Health Behaviors & Chronic Diseases
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Male
Rural Population
Longitudinal study
Malawi
Binomial regression
0302 clinical medicine
Health facility
030212 general & internal medicine
Longitudinal Studies
Laboratory of Entomology
Malaria
Falciparum
Family Characteristics
biology
Under-five
Incidence
1. No poverty
Anopheles
PE&RC
3. Good health
Infectious Diseases
Child
Preschool
Cohort
Epidemiological Monitoring
Female
Adult
medicine.medical_specialty
030231 tropical medicine
Plasmodium falciparum
Mosquito Vectors
Incidence rate
lcsh:Infectious and parasitic diseases
03 medical and health sciences
Spatio-Temporal Analysis
parasitic diseases
medicine
Humans
lcsh:RC109-216
Spatio-temporal heterogeneity
Research
Infant
Entomological surveillance
DNA
Protozoan
Laboratorium voor Entomologie
biology.organism_classification
medicine.disease
Malaria
Logistic Models
Tropical medicine
Parasitology
Demography
Zdroj: Parasites & Vectors
Parasites & Vectors, Vol 11, Iss 1, Pp 1-11 (2018)
Parasites & vectors, 11(1):129. BioMed Central
Parasites and Vectors 11 (2018) 1
Parasites and Vectors, 11(1)
ISSN: 1756-3305
Popis: Background Spatio-temporal variations in malaria burden are currently complex and costly to measure, but are important for decision-making. We measured the spatio-temporal variation of clinical malaria incidence at a fine scale in a cohort of children under five in an endemic area in rural Chikhwawa, Malawi, determined associated factors, and monitored adult mosquito abundance. Methods We followed-up 285 children aged 6–48 months with recorded geolocations, who were sampled in a rolling malaria indicator survey, for one year (2015–2016). Guardians were requested to take the children to a nearby health facility whenever ill, where health facility personnel were trained to record malaria test results and temperature on the child’s sick-visit card; artemisinin-based combination therapy was provided if indicated. The cards were collected and replaced 2-monthly. Adult mosquitoes were collected from 2-monthly household surveys using a Suna trap. The head/thorax of adult Anopheles females were tested for presence of Plasmodium DNA. Binomial logistic regression and geospatial modelling were performed to determine predictors of and to spatially predict clinical malaria incidence, respectively. Results Two hundred eighty two children, with complete results, and 267.8 child-years follow-up time were included in the analysis. The incidence rate of clinical malaria was 1.2 cases per child-year at risk; 57.1% of the children had at least one clinical malaria case during follow-up. Geographical groups of households where children experienced repeated malaria infections overlapped with high mosquito densities and high entomological inoculation rate locations. Conclusions Repeated malaria infections within household groups account for the majority of cases and signify uneven distribution of malaria risk within a small geographical area. Electronic supplementary material The online version of this article (10.1186/s13071-018-2730-y) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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