肯尼亚下维多利亚湖流域不同海拔疟疾传播的时空变化

Samwel Odhiambo Olela, G. L. Makokha, K. Obiero
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摘要

目的:疟疾传播是气候变率和变化的后果之一。在热带地区的发展中国家,特别是撒哈拉以南的非洲,这种负担最重。在肯尼亚,特别是下维多利亚湖盆地(LLVB),它被归咎于历史上的高降雨量、温度和相对湿度。本研究旨在确定肯尼亚LLVB不同海拔地区疟疾传播的时空变化。方法:该研究依赖于卫生信息系统10年来存档的常规疟疾病例传播记录的数据。卡卡梅加县、基苏木县和米戈里县的数据通过次县卫生设施从肯尼亚卫生信息系统(KHIS)获得。使用Pearson积矩相关系数对疑似和确诊的传播病例进行关联。采用方差分析(ANOVA)检验传播的可变性,采用时间序列(Time Series)确定传播特征,采用疟疾病例传播表和Tukeys Honest Significance Difference (HSD)检验疟疾分布的显著性。结果:在米戈里县和卡卡梅加县发现疑似病例被夸大了。在研究期间,疟疾传播因海拔、空间和时间而异。基苏木县和卡卡梅加县呈上升趋势,而米戈里县呈下降趋势。传播描述了研究地区的地方性和流行病特征。对理论、政策和实践的独特贡献:肯尼亚内省的卫生设施应配备更现代化的实验室设备,以改进对传播的确认,从而减少怀疑。由于大多数观察证实疟疾传播的性质随海拔的不同而不同,因此应停止对肯尼亚内陆地区疟疾传播的一概而论的假设。肯尼亚LLVB应按海拔高度划分区域,以便实施有效的缓解和根除战略。Migori县疟疾病例传播的减少表明未来可能消灭疟疾。其原因应调查和推断到其他国家。需要进行更多的研究,以便在其他地方建立有效管理和控制传播的情况。这些启示和建议有望加强肯尼亚LLVB的疟疾根除工作,并随后促进肯尼亚2030年愿景的实现。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Spatiotemporal Variation of Malaria Transmission in Different Altitudes of Lower Lake Victoria Basin, Kenya
Purpose: Malaria transmission is one of the consequences of climate variability and change. The burden is greatest in the developing countries of the tropics especially Africa south of the Sahara. In Kenya, particularly the Lower Lake Victoria Basin (LLVB), it is blamed on the historical high rainfall, temperature and relative humidity. This study sought to determine spatiotemporal variation of malaria transmission in different altitudes of the LLVB, Kenya. Methodology: The study relied on data from routine malaria case transmission records archived by the Health Information System for ten years. Data for Kakamega, Kisumu and Migori Counties were obtained from the Kenya Health Information System (KHIS) through Sub-County Health Facilities. Pearson’s Product Moment Correlation Coefficient was used to correlate the suspected and confirmed transmission cases. ANOVA was used in testing the variability of transmission, Time Series to determine transmission characteristics while malaria case transmission tables and Tukeys Honest Significance Difference (HSD) were for testing the significance of the distribution of malaria. Findings: The suspected cases were found to have been overstated in Migori and Kakamega Counties. Malaria transmission varied by altitude, space and time during the study period. Trends increased in Kisumu and Kakamega Counties while it decreased in Migori County. Transmission depicted both endemic and epidictic characteristics in the study area. Unique Contribution to Theory, Policy and Practices: Health facilities in the LLVB, Kenya should be equipped with more modern laboratory equipment to improve confirmation of transmission so as to reduce suspicions. Since most of the observations confirmed the varying nature of malaria transmission in relation to altitude, the aspect of blanket assumption concerning malaria transmission in the LLVB, Kenya should be stopped. LLVB, Kenya should be zoned by altitudes for effective mitigation and eradication strategies. The reduction of malaria case transmission in Migori County was an indication of possible future eradication. Its cause should be investigated and inferred to other counties. More research is necessary to establish situations elsewhere for effective management and control of transmissions. The revelations and recommendations were expected to enhance malaria eradication in the LLVB, Kenya and subsequently promote the realization of Kenya’s vision 2030.
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