High Prevalence of Malaria in Zambezia, Mozambique The Protective Effect of IRS versus Increased Risks Due to Pig-Keeping and House Construction 英文参考文献.docVIP

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High Prevalence of Malaria in Zambezia, Mozambique The Protective Effect of IRS versus Increased Risks Due to Pig-Keeping and House Construction 英文参考文献.doc

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High Prevalence of Malaria in Zambezia, Mozambique The Protective Effect of IRS versus Increased Risks Due to Pig-Keeping and House Construction 英文参考文献

HighPrevalenceofMalariainZambezia,Mozambique: TheProtectiveEffectofIRSversusIncreasedRisksDueto Pig-KeepingandHouseConstruction EmmanuelA.Temu1,MikeColeman2*,AnaPaulaAbilio3,ImmoKleinschmidt4 1LondonSchoolofHygieneandTropicalMedicine,London,UnitedKingdom,2LiverpoolSchoolofTropicalMedicine,Liverpool,UnitedKingdom,3NationalInstituteof Health,Maputo,Mozambique,4TropicalEpidemiologyGroup,LondonSchoolofHygieneandTropicalMedicine,London,UnitedKingdom Abstract Background: African countries are scaling up malaria interventions, especially insecticide treated nets (ITN) and indoor residualspraying(IRS),forwhichambitiouscoveragetargetshavebeenset.Inspiteoftheseeffortsinfectionprevalence remainshighinmanypartsofthecontinent.Thisstudyinvestigatedriskfactorsformalariainfectioninchildrenusingthree malariaindicatorsurveysfromZambeziaprovince,Mozambique.TheimpactofIRSandITNs,theeffectsofkeepingfarm animalsandoftheconstructionmaterialofroofsofhousesandotherpotentialriskfactorsassociatedwithmalariainfection inchildrenwereassessed. Methods:Cross-sectionalcommunity-basedsurveyswereconductedinOctoberof2006,2007and2008.Atotalof8338 children(ages1–15years)from2748householdswereincludedinthestudy.Allchildrenwerescreenedformalariabyrapid diagnostictests.CaregiverinterviewswereusedtoassesshouseholddemographicandwealthcharacteristicsandITNand IRScoverage.Associationsbetweenmalariainfection,vectorcontrolinterventionsandpotentialriskfactorswereassessed. Results:Overall,theprevalenceofmalariainfectionwas47.8%(95%CI:38.7%–57.1%)inchildren1–15yearsofage,lessthan aquarterofchildren(23.1%,95%CI:19.1%–27.6%)weresleepingunderITNandalmosttwothirdswerelivinginIRStreated houses(coverage65.4%,95%CI:51.5%–77.0%).Protectivefactorsthatwereindependentlyassociatedwithmalariainfection were:sleepinginanIRShousewithoutsleepingunderITN(OddsRatio(OR) =0.6;95%CI:0.4–0.9);additionalprotectiondue tosleepingunderITNinanIRStreatedhouse(OR=0.5;95%CI:0.3–0.7)versussleepinginanunsprayedhousewithouta ITN;andparentaled