THE EPIDEMIOLOGY OF MALARIA IN THE WOSERA AREA, EAST SEPIK PROVINCE, PAPUA-NEW-GUINEA, IN PREPARATION FOR VACCINE TRIALS .2. MORTALITY AND MORBIDITY

被引:72
作者
GENTON, B
ALYAMAN, F
BECK, HP
HII, J
MELLOR, S
RARE, L
GINNY, M
SMITH, T
ALPERS, MP
机构
[1] JAMES COOK UNIV N QUEENSLAND,DEPT PUBL HLTH & TROP MED,TOWNSVILLE,QLD 4811,AUSTRALIA
[2] SWISS TROP INST,CH-4002 BASEL,SWITZERLAND
来源
ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY | 1995年 / 89卷 / 04期
关键词
D O I
10.1080/00034983.1995.11812966
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Malaria mortality and morbidity were studied in a rural population of 4000 in the Wosera area, East Sepik Province, Papua New Guinea, Malaria accounted for 4.9% of the 162 deaths investigated by verbal autopsy and for 12.2% of the 49 deaths assessed through medical records. Malaria was the first cause of death in children aged 0.5-4 years. Of the 7795 subjects interviewed and bled during six cross-sectional community-based surveys, children of 1-4 years had the highest malaria-related morbidity. In this age group, point prevalences of fever, fever associated with parasitaemia, and fever plus Plasmodium falciparum (Pf) (Pf) parasitaemia greater than or equal to 10000 parasites/mu l blood were 5%, 4.1% and 1.5%, respectively. The corresponding figures for adults were 2%, 0.9% and 0.1%, respectively. The calculation of attributable fraction (AF) using a multiple logistic regression model showed that malaria accounted for 0.44 of all fevers in children of 1-4 years and 0.08 of the fevers in adults. Prevalence data derived from the AF estimate were compared with those calculated using different accepted density thresholds. The prevalences which best approximated the results from the logistic regression model were obtained using parasitaemia cut-offs of greater than or equal to 1000 Pf parasites/mu l in children aged 1-4 years and adults older than 19 years and of greater than or equal to 10000 parasites/mu l in those aged 5-19 years. Prevalence of fever associated with parasitaemia was highly seasonal, with a peak at the beginning of the wet season. The geographical distribution of malaria morbidity was not uniform. The measurement of malaria-related morbidity, the identification of significant seasonal and local variation as well as the assessment of different methods of defining a clinical episode of PE malaria are crucial for the design and evaluation of intervention studies, including field trials of antimalarial vaccines.
引用
收藏
页码:377 / 390
页数:14
相关论文
共 30 条
  • [1] A MALARIA CONTROL TRIAL USING INSECTICIDE-TREATED BED NETS AND TARGETED CHEMOPROPHYLAXIS IN A RURAL AREA OF THE GAMBIA, WEST-AFRICA .6. THE IMPACT OF THE INTERVENTIONS ON MORTALITY AND MORBIDITY FROM MALARIA
    ALONSO, PL
    LINDSAY, SW
    SCHELLENBERG, JRMA
    KEITA, K
    GOMEZ, P
    SHENTON, FC
    HILL, AG
    DAVID, PH
    FEGAN, G
    CHAM, K
    GREENWOOD, BM
    [J]. TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE, 1993, 87 : 37 - 44
  • [2] RANDOMIZED TRIAL OF EFFICACY OF SPF66 VACCINE AGAINST PLASMODIUM-FALCIPARUM MALARIA IN CHILDREN IN SOUTHERN TANZANIA
    ALONSO, PL
    SMITH, T
    SCHELLENBERG, JRMA
    MASANJA, H
    MWANKUSYE, S
    URASSA, H
    DEAZEVEDO, IB
    CHONGELA, J
    KOBERO, S
    MENENDEZ, C
    HURT, N
    THOMAS, MC
    LYIMO, E
    WEISS, NA
    HAYES, R
    KITUA, AY
    LOPEZ, MC
    KILAMA, WL
    TEUSCHER, T
    TANNER, M
    [J]. LANCET, 1994, 344 (8931) : 1175 - 1181
  • [3] ALPERS MP, 1992, PAPUA NEW GUINEA MED, V35, P285
  • [4] ALYAMAN F, 1994, PAPUA NEW GUINEA MED, V37, P54
  • [5] BETSCHART B, 1986, ACTA TROP, V43, P125
  • [6] THE EPIDEMIOLOGY OF MALARIA IN A POPULATION SURROUNDING MADANG, PAPUA-NEW-GUINEA
    CATTANI, JA
    TULLOCH, JL
    VRBOVA, H
    JOLLEY, D
    GIBSON, FD
    MOIR, JS
    HEYWOOD, PF
    ALPERS, MP
    STEVENSON, A
    CLANCY, R
    [J]. AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE, 1986, 35 (01) : 3 - 15
  • [7] DYNAMICS OF MALARIA PARASITEMIA ASSOCIATED WITH FEBRILE ILLNESS IN CHILDREN FROM A RURAL AREA OF MADANG, PAPUA-NEW-GUINEA
    COX, MJ
    KUM, DE
    TAVUL, L
    NARARA, A
    RAIKO, A
    BAISOR, M
    ALPERS, MP
    MEDLEY, GF
    DAY, KP
    [J]. TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE, 1994, 88 (02) : 191 - 197
  • [8] DELFINI LF, 1973, J TROP MED HYG, V76, P111
  • [9] MALARIA - HOW USEFUL ARE CLINICAL-CRITERIA FOR IMPROVING THE DIAGNOSIS IN A HIGHLY ENDEMIC AREA
    GENTON, B
    SMITH, T
    BAEA, K
    NARARA, A
    ALYAMAN, F
    BECK, HP
    HII, J
    ALPERS, M
    [J]. TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE, 1994, 88 (05) : 537 - 541
  • [10] GENTON B, 1995, ANN TROPICAL MED PAR, V89