Relating household entomological measures to individual malaria risk.

IF 3 3区医学 Q3 INFECTIOUS DISEASES

Malaria Journal Pub Date : 2025-08-14 DOI:10.1186/s12936-025-05504-5

Max McClure, Emmanuel Arinaitwe, Moses R Kamya, Philip J Rosenthal, Joaniter Nankabirwa, Maxwell Kilama, Alex Musiime, Grant Dorsey, Bryan Greenhouse, Isabel Rodriguez-Barraquer

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引用次数: 0

Abstract

Background: The gold standard measure of malaria exposure is the entomological inoculation rate (EIR), or the number of infectious bites an individual receives over a given period. Nevertheless, it is unclear whether EIR measured in the households of individuals reflects heterogeneity in those individuals' infection risk.

Methods: To investigate this relationship, this study used data collected from a cohort of 439 children aged 0.5-5 years in 239 households from 2011-2016 in three Ugandan districts: low-EIR Jinja, intermediate-EIR Kanungu and high-EIR Tororo. Participants underwent passive and quarterly active surveillance for clinical malaria, defined as fever with positive thick blood smear. Monthly vector densities and sporozoite rates in participating households were estimated using CDC light traps. The association between spatiotemporally smoothed household log₂-transformed EIR and individual malaria incidence was assessed using Poisson generalized additive mixed effects models.

Results: Comparison across sites suggested an increasing relationship between average EIR and malaria incidence. Within-site relationships, however, varied by site, with a positive association in Kanungu (incidence rate ratio [IRR] 1.09, 95% credible interval 1.04-1.14) but none in Jinja (1.02, 0.774-1.26) or Tororo (1.02, 0.986-1.06).

Conclusions: These results show the relationship between measured EIR and malaria incidence may depend on site-specific transmission dynamics and be strongest at intermediate EIR, while underscoring the challenges of using household-level measures of exposure.

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将家庭昆虫学措施与个人疟疾风险联系起来。

背景：衡量疟疾暴露的金标准是昆虫接种率（EIR），或在给定时期内个体受到传染性叮咬的次数。然而，目前尚不清楚在个体家庭中测量的EIR是否反映了这些个体感染风险的异质性。方法：为了调查这种关系，本研究使用了2011-2016年在乌干达三个地区（低eir金贾、中等eir卡农古和高eir托罗罗）239个家庭中收集的439名0.5-5岁儿童的数据。参与者对临床疟疾进行被动和季度主动监测，定义为伴有粘稠血涂片阳性的发热。采用CDC灯诱法估计参与家庭的每月病媒密度和孢子虫率。利用Poisson广义加性混合效应模型评估了时空平滑的家庭log2转换EIR与个体疟疾发病率之间的关系。结果：不同地点的比较表明，平均EIR与疟疾发病率之间的关系越来越密切。然而，在不同的站点内，不同的站点之间的关系不同，卡努古的发病率为正相关（发病率比[IRR] 1.09, 95%可信区间1.04-1.14），而金贾（1.02,0.774-1.26）和托罗罗（1.02,0.986-1.06）无相关。结论：这些结果表明，测量的EIR与疟疾发病率之间的关系可能取决于特定地点的传播动态，并且在中等EIR时最强，同时强调了使用家庭水平暴露测量的挑战。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Malaria Journal 医学-寄生虫学

CiteScore

5.10

自引率

23.30%

发文量

334

审稿时长

2-4 weeks

期刊介绍： Malaria Journal is aimed at the scientific community interested in malaria in its broadest sense. It is the only journal that publishes exclusively articles on malaria and, as such, it aims to bring together knowledge from the different specialities involved in this very broad discipline, from the bench to the bedside and to the field.