Human malaria in the highlands of Yemen.

A M Al-Mekhlafi, H M Al-Mekhlafi, M A K Mahdy, A A Azazy, M Y Fong
{"title":"Human malaria in the highlands of Yemen.","authors":"A M Al-Mekhlafi, H M Al-Mekhlafi, M A K Mahdy, A A Azazy, M Y Fong","doi":"10.1179/136485911X12987676649421","DOIUrl":null,"url":null,"abstract":"<p><p><title/> Between June 2008 and March 2009, a cross-sectional study of human malaria was carried out in four governorates of Yemen, two (Taiz and Hodiedah) representing the country's highlands and the others (Dhamar and Raymah) the country's coastal plains/foothills. The main aims were to determine the prevalences of Plasmodium infection among 455 febrile patients presenting for care at participating health facilities and to investigate the potential risk factors for such infection. Malarial infection was detected in 78 (17·1%) of the investigated patients and was more likely to be detected among the febrile patients from the highlands than among those presenting in the coastal plains/foothills (22·6% v.13·9%; χ(2)=10·102; P=0·018). Binary logistic-regression models identified low household income [odds ratio (OR)=13·52; 95% confidence interval (CI)=2·62-69·67; P=0·002], living in a household with access to a water pump (OR=4·18; CI=1·60-10·96; P=0·004) and living in a household near a stream (OR=4·43; CI=1·35-14·56; P=0·014) as significant risk factors for malarial infection in the highlands. Low household income was the only significant risk factor identified for such infection in the coastal plains and foothills (OR = 8·20; CI=1·80-37·45; P=0·007). It is unclear why febrile patients in the highlands of Yemen are much more likely to be found to have malarial infection than their counterparts from the coastal plains and foothills. Although it is possible that malarial transmission is relatively intense in the highlands, it seems more likely that, compared with those who live at lower altitudes, those who live in the highlands are less immune to malaria, and therefore more likely to develop febrile illness following malarial infection. Whatever the cause of the symptomatic malarial infection commonly found in the highlands of Yemen, it is a matter of serious concern that should be addressed in the national strategy to control malaria.</p>","PeriodicalId":8019,"journal":{"name":"Annals of tropical medicine and parasitology","volume":"105 3","pages":"187-95"},"PeriodicalIF":0.0000,"publicationDate":"2011-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4090792/pdf/atm-105-03-187.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of tropical medicine and parasitology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1179/136485911X12987676649421","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
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Abstract

Between June 2008 and March 2009, a cross-sectional study of human malaria was carried out in four governorates of Yemen, two (Taiz and Hodiedah) representing the country's highlands and the others (Dhamar and Raymah) the country's coastal plains/foothills. The main aims were to determine the prevalences of Plasmodium infection among 455 febrile patients presenting for care at participating health facilities and to investigate the potential risk factors for such infection. Malarial infection was detected in 78 (17·1%) of the investigated patients and was more likely to be detected among the febrile patients from the highlands than among those presenting in the coastal plains/foothills (22·6% v.13·9%; χ(2)=10·102; P=0·018). Binary logistic-regression models identified low household income [odds ratio (OR)=13·52; 95% confidence interval (CI)=2·62-69·67; P=0·002], living in a household with access to a water pump (OR=4·18; CI=1·60-10·96; P=0·004) and living in a household near a stream (OR=4·43; CI=1·35-14·56; P=0·014) as significant risk factors for malarial infection in the highlands. Low household income was the only significant risk factor identified for such infection in the coastal plains and foothills (OR = 8·20; CI=1·80-37·45; P=0·007). It is unclear why febrile patients in the highlands of Yemen are much more likely to be found to have malarial infection than their counterparts from the coastal plains and foothills. Although it is possible that malarial transmission is relatively intense in the highlands, it seems more likely that, compared with those who live at lower altitudes, those who live in the highlands are less immune to malaria, and therefore more likely to develop febrile illness following malarial infection. Whatever the cause of the symptomatic malarial infection commonly found in the highlands of Yemen, it is a matter of serious concern that should be addressed in the national strategy to control malaria.</p> </div> <div class="wenb"> <input type="hidden" id="iswx" value="0" /> <div class="fenx"> <span class="fenicon" id="share"> <svg t="1706512202889" class="" viewBox="0 0 1024 1024" version="1.1" xmlns="http://www.w3.org/2000/svg" p-id="4368" width="14" height="14"><path d="M696.2 615.1c-35.4 0-67.4 14.1-91 36.8L354 526.3c0.7-5.3 1.1-10.7 1.1-16.2s-0.4-10.9-1.1-16.2l251.2-125.6c23.6 22.7 55.6 36.8 91 36.8 72.5 0 131.2-58.7 131.2-131.2s-58.7-131.2-131.2-131.2S565 201.5 565 273.9c0 5.5 0.4 10.9 1.1 16.2L314.9 415.7c-23.6-22.7-55.6-36.8-91-36.8-72.5 0-131.2 58.7-131.2 131.2s58.7 131.2 131.2 131.2c35.4 0 67.4-14.1 91-36.8l251.2 125.6c-0.7 5.3-1.1 10.7-1.1 16.2 0 72.5 58.7 131.2 131.2 131.2s131.2-58.7 131.2-131.2-58.8-131.2-131.2-131.2z" fill="#221714" p-id="4369"></path></svg> 分享 </span> </div> <a class="Left" href="https://doi.org/10.1179/136485911X12987676649421" target="_blank">查看原文</a> <a class="Left" href="/literature_d8019.htm" target="_blank">本刊更多论文</a> </div> <div> <div class="zxqknr">也门高地的人类疟疾。</div> <div class="wenct">2008 年 6 月至 2009 年 3 月期间,在也门的四个省开展了一项人类疟疾横断面研究,其中两个省(塔伊兹和霍迪达)位于该国的高原地区,其他两个省(达马尔和雷马)位于该国的沿海平原/山麓地区。研究的主要目的是确定在参与研究的医疗机构就诊的 455 名发热病人中疟原虫感染的流行率,并调查这种感染的潜在风险因素。在调查的患者中,78人(17-1%)被检测出疟原虫感染,来自高原地区的发热患者比来自沿海平原/山麓地区的患者更容易被检测出疟原虫感染(22-6% 对 13-9%;χ(2)=10-102;P=0-018)。二元逻辑回归模型发现,家庭收入低[几率比(OR)=13-52;95% 置信区间(CI)=2-62-69-67;P=0-002]、生活在有水泵的家庭(OR=4-18;CI=1-60-10-96;P=0-004)和生活在溪流附近的家庭(OR=4-43;CI=1-35-14-56;P=0-014)是高原地区疟疾感染的重要风险因素。在沿海平原和山麓地区,家庭收入低是此类感染的唯一显著风险因素(OR=8-20;CI=1-80-37-45;P=0-007)。目前还不清楚为什么也门高原地区的发热病人比沿海平原和山麓地区的发热病人更容易感染疟疾。虽然疟疾在高原地区的传播可能相对较强,但更有可能的是,与生活在低海拔地区的人相比,生活在高原地区的人对疟疾的免疫力较低,因此更有可能在感染疟疾后出现发热症状。无论也门高地常见的无症状疟疾感染的原因是什么,这都是一个令人严重关切的问题,应在国家疟疾控制战略中加以解决。</div> <div class="zxqkt">本文章由计算机程序翻译,如有差异,请以英文原文为准。</div> </div> </div> <div class="qzq 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