Risk of malaria attacks in Gambian children is greater away from malaria vector breeding sites

被引:60
作者
Clarke, SE
Bogh, C
Brown, RC
Walraven, GEL
Thomas, CJ
Lindsay, SW
机构
[1] Danish Bilharziasis Lab, DK-2920 Charlottenlund, Denmark
[2] Farafenni & Fajara, Med Res Council Labs, Banjul, Gambia
[3] Univ Durham, Sch Biol & Biomed Sci, Durham DH1 3LE, England
基金
英国医学研究理事会;
关键词
malaria; Plasmodium falciparum; children; entomological inoculation rate; clinical attack prevalence; The Gambia;
D O I
10.1016/S0035-9203(02)90419-0
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
The causes of local variation in the prevalence of malaria were investigated in rural Gambia. Cross-sectional prevalence surveys were carried out among 1184 young children (aged 6 months-5 years) in 48 villages, at the end of the transmission season in 1996. Villages were categorized according to distance from the nearest vector breeding sites, and the patterns of malaria transmission, infection and disease compared. Children living in villages within 3 km of breeding sites experienced more infective bites, and higher prevalences of parasitaemia and spleen enlargement than less-exposed children living further away. Clinical illness, in contrast, was more common among infected children who were less exposed. Infected children living 3 km or more from breeding sites were more likely to have high-density parasitaemia (odds ratio [OR] = 1.98), fever (OR = 2.60) and high-density parasitaemia together with fever (OR = 3.17). Clinical attacks did not decline in older children, as seen amongst children who were more exposed. These findings show that significant differences in the risk of infection and clinical attacks can occur over very short distances. The age at which protective immunity is acquired may be delayed in villages where transmission intensity is lower, thus increasing the risk of a clinical attack following infection. Communities with the lowest vector densities may be those at greatest risk of disease.
引用
收藏
页码:499 / 506
页数:8
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