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Use of Insecticide-Treated Mosquito Net among Pregnant Women and Guardians of Children under Five in the Democratic Republic of the Congo. 刚果民主共和国孕妇和五岁以下儿童监护人使用驱虫蚊帐的情况。
Q2 Medicine Pub Date : 2017-01-01 Epub Date: 2017-11-06 DOI: 10.1155/2017/5923696
Joseph N Inungu, Nestor Ankiba, Mark Minelli, Vincent Mumford, Dido Bolekela, Bienvenu Mukoso, Willy Onema, Etienne Kouton, Dolapo Raji

Background: Insecticide-treated mosquito nets (ITNs) are one of the most effective tools for preventing malaria in sub-Saharan Africa.

Objective: This study examined knowledge, attitude, and practice on the use of ITNs in the prevention of malaria among pregnant women and guardians of children under five in the Democratic Republic of the Congo.

Methods: A total of 5,138 pregnant women and guardians of children under five were interviewed.

Results: The majority of participants (>80%) knew the signs and symptoms of malaria; 81.6% reported having an ITN in the household, but 78.4% reported using it the night before the interview. Only 71.4% of pregnant women used ITN the night compared to 68.2% of children under five. In the Logistic Regression model, women who believed that it is normal to use ITNs were 1.9 times more likely to use it than those who did not (OR: 1.930); women who were confident in their abilities to use ITNs were 1.9 times more likely than those who were not confident (OR: 1.915); and women who had a good attitude towards ITNs were also more likely to use ITNs compared to those who did not (OR: 1.529).

Conclusion: New and innovative evidence-based behavior change interventions are needed to increase the utilization of ITNs among vulnerable groups.

背景:经杀虫剂处理的蚊帐(ITNs)是撒哈拉以南非洲预防疟疾最有效的工具之一。目的:本研究调查了刚果民主共和国孕妇和5岁以下儿童监护人在使用蚊帐预防疟疾方面的知识、态度和做法。方法:对5138名孕妇及5岁以下儿童的监护人进行访谈。结果:大多数参与者(>80%)知道疟疾的体征和症状;81.6%的人表示家中有ITN,但78.4%的人表示在采访前一晚使用过ITN。只有71.4%的孕妇在夜间使用ITN,而5岁以下儿童的这一比例为68.2%。在Logistic回归模型中,认为使用itn是正常的女性使用itn的可能性是不使用itn的女性的1.9倍(OR: 1.930);对自己使用itn能力有信心的女性使用itn的可能性是不自信的女性的1.9倍(OR: 1.915);对ITNs有良好态度的女性使用ITNs的可能性也高于不使用ITNs的女性(OR: 1.529)。结论:需要创新的基于证据的行为改变干预措施来提高弱势群体对ITNs的利用。
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引用次数: 30
Low Utilization of Insecticide-Treated Bed Net among Pregnant Women in the Middle Belt of Ghana. 加纳中部地区孕妇驱虫蚊帐使用率低。
Q2 Medicine Pub Date : 2017-01-01 Epub Date: 2017-07-30 DOI: 10.1155/2017/7481210
Grace Manu, Ellen Abrafi Boamah-Kaali, Lawrence Gyabaa Febir, Emmanuel Ayipah, Seth Owusu-Agyei, Kwaku Poku Asante

Background: Malaria in pregnancy leads to low birth weight, premature birth, anaemia, and maternal and neonatal mortality. Use of insecticide-treated nets (ITNs) during pregnancy is one of the proven interventions to reduce the malaria burden. However, Ghana has not achieved its target for ITN use among pregnant women.

Methods: A qualitative study was conducted in seven communities purposively selected from the middle belt of Ghana. Participants who had delivered in the six months prior to this study were selected. In all, seven focus group discussions and twenty-four in-depth interviews were conducted between June and August 2010.

Results: Respondents knew of the importance of ITNs and other malaria-preventive strategies. Factors such as financial access and missed opportunities of free distribution denied some pregnant women the opportunity to own or use an ITN. Reasons for not using ITNs during pregnancy included discomfort resulting from heat, smell of the net, and difficulty in hanging the net. Participants maintained their ITNs by preventing holes in the nets, retreatment, and infrequent washing.

Conclusion: Pregnant women know about the causes and prevention of malaria. However, this knowledge is not transformed into practice due to lack of access to ITNs and sleeping discomforts among other logistical constraints.

背景:妊娠期疟疾导致低出生体重、早产、贫血以及孕产妇和新生儿死亡率。在怀孕期间使用经杀虫剂处理的蚊帐是一种经证实的减少疟疾负担的干预措施。然而,加纳还没有实现在孕妇中使用蚊帐的目标。方法:在加纳中部地带有意选择的7个社区进行定性研究。在这项研究之前的六个月内分娩的参与者被选中。在2010年6月至8月期间,共进行了7次焦点小组讨论和24次深度访谈。结果:应答者知道ITNs和其他疟疾预防策略的重要性。诸如经济条件和错过免费分发的机会等因素使一些孕妇没有机会拥有或使用蚊帐。怀孕期间不使用蚊帐的原因包括热引起的不适、蚊帐的气味和悬挂蚊帐的困难。参与者通过防止蚊帐破洞、重新处理和不经常清洗来维护他们的蚊帐。结论:孕妇对疟疾的病因及防治有所了解。然而,由于缺乏获得ITNs和睡眠不适以及其他后勤限制,这些知识没有转化为实践。
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引用次数: 52
Detection of Plasmodium Aldolase Using a Smartphone and Microfluidic Enzyme Linked Immunosorbent Assay. 应用智能手机和微流控酶联免疫吸附法检测醛缩酶。
Q2 Medicine Pub Date : 2017-01-01 Epub Date: 2017-09-06 DOI: 10.1155/2017/9062514
Nikhil S Gopal, Ruben Raychaudhuri

Background: Malaria control efforts are limited in rural areas. A low-cost system to monitor response without the use of electricity is needed. Plasmodium aldolase is a malaria biomarker measured using enzyme linked immunosorbent assay (ELISA) techniques. A three-part system using ELISA was developed consisting of a microfluidic chip, hand crank centrifuge, and a smartphone.

Methods: A circular microfluidic chip was fabricated using clear acrylic and a CO2 laser. A series of passive valves released reagents at precise times based upon centrifugal force. Color change was measured via smartphone camera using an application programmed in Java. The microchip was compared to a standard 96-well sandwich ELISA.

Results: Results from standard ELISA were compared to microchip at varying concentrations (1-10 ng/mL). Over 15 different microfluidic patterns were tested, and a final prototype of the chip was created. The prototype microchip was compared to standard sandwich ELISA (n = 20) using samples of recombinant aldolase. Color readings of standard ELISA and microfluidic microchip showed similar results.

Conclusion: A low-cost microfluidic system could detect and follow therapeutic outcomes in rural areas and identify resistant strains.

背景:农村地区疟疾控制工作有限。需要一种低成本的系统来监测不用电的反应。醛缩疟原虫酶是一种使用酶联免疫吸附测定(ELISA)技术测定的疟疾生物标志物。采用酶联免疫吸附试验开发了一个由微流控芯片、手摇离心机和智能手机组成的三部分系统。方法:采用透明丙烯酸树脂和CO2激光器制备圆形微流控芯片。一系列被动阀门根据离心力在精确的时间释放试剂。颜色变化是通过使用Java编程的应用程序通过智能手机摄像头测量的。将该微芯片与标准96孔夹心ELISA进行比较。结果:将不同浓度(1 ~ 10 ng/mL)的标准ELISA检测结果与微芯片检测结果进行比较。测试了超过15种不同的微流体模式,并创建了芯片的最终原型。使用重组醛缩酶样品将原型芯片与标准夹心ELISA (n = 20)进行比较。标准ELISA和微流控芯片的颜色读数显示相似的结果。结论:一种低成本的微流控系统可以检测和跟踪农村地区的治疗效果,并识别耐药菌株。
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引用次数: 3
Nonobese Diabetic (NOD) Mice Lack a Protective B-Cell Response against the “Nonlethal” Plasmodium yoelii 17XNL Malaria Protozoan 非肥胖糖尿病(NOD)小鼠对“非致死性”约氏疟原虫17XNL疟疾原生动物缺乏保护性b细胞反应
Q2 Medicine Pub Date : 2016-12-15 DOI: 10.1155/2016/6132734
Mirian Mendoza, Luis Pow Sang, Q. Qiu, S. Casares, T. Brumeanu
Background. Plasmodium yoelii 17XNL is a nonlethal malaria strain in mice of different genetic backgrounds including the C57BL/6 mice (I-Ab/I-Enull) used in this study as a control strain. We have compared the trends of blood stage infection with the nonlethal murine strain of P. yoelii 17XNL malaria protozoan in immunocompetent Nonobese Diabetic (NOD) mice prone to type 1 diabetes (T1D) and C57BL/6 mice (control mice) that are not prone to T1D and self-cure the P. yoelii 17XNL infection. Prediabetic NOD mice could not mount a protective antibody response to the P. yoelii 17XNL-infected red blood cells (iRBCs), and they all succumbed shortly after infection. Our data suggest that the lack of anti-P. yoelii 17XNL-iRBCs protective antibodies in NOD mice is a result of parasite-induced, Foxp3+ T regulatory (Treg) cells able to suppress the parasite-specific antibody secretion. Conclusions. The NOD mouse model may help in identifying new mechanisms of B-cell evasion by malaria parasites. It may also serve as a more accurate tool for testing antimalaria therapeutics due to the lack of interference with a preexistent self-curing mechanism present in other mouse strains.
背景。约利疟原虫17XNL是一种非致死性疟疾菌株,可感染不同遗传背景的小鼠,包括本研究中作为对照菌株的C57BL/6小鼠(I-Ab/I-Enull)。我们比较了易患1型糖尿病(T1D)的免疫能力强的非肥胖糖尿病(NOD)小鼠和不易患T1D的C57BL/6小鼠(对照小鼠)血液阶段感染P. yoelii 17XNL疟疾原生动物的趋势。糖尿病前期NOD小鼠不能对P. yoelii 17xnl感染的红细胞(irbc)产生保护性抗体反应,并且在感染后不久就全部死亡。我们的数据表明,缺乏抗p。NOD小鼠中的yoelii 17xnl - irbc保护性抗体是寄生虫诱导的结果,Foxp3+ T调节(Treg)细胞能够抑制寄生虫特异性抗体的分泌。结论。NOD小鼠模型可能有助于确定b细胞逃避疟疾寄生虫的新机制。它还可以作为一种更准确的工具来测试抗疟疾疗法,因为它不干扰其他小鼠品系中存在的预先存在的自愈机制。
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引用次数: 10
Burden of Placental Malaria among Pregnant Women Who Use or Do Not Use Intermittent Preventive Treatment at Mulago Hospital, Kampala 坎帕拉穆拉戈医院使用或不使用间歇预防性治疗的孕妇的胎盘疟疾负担
Q2 Medicine Pub Date : 2016-12-13 DOI: 10.1155/2016/1839795
C. Odongo, M. Odida, H. Wabinga, C. Obua, J. Byamugisha
Intermittent preventive treatment of malaria in pregnancy with sulphadoxine-pyrimethamine (SP-IPTp) is widely used to reduce the incidence of adverse pregnancy outcomes. As a monitor for continued effectiveness of this intervention amidst SP resistance, we aimed to assess malaria burden among pregnant women who use or do not use SP-IPTp. In a descriptive cohort study at Mulago Hospital, Kampala, 87 women who received two supervised doses of SP-IPTp were followed up until delivery. Controls were pregnant women presenting in early labour without history of SP-IPTp. Histopathological investigation for placental malaria (PM) was performed using the Bulmer classification criterion. Thirty-eight of the 87 women returned for delivery and 33 placentas were successfully collected and processed along with 33 placentas from SP nonusers. Overall, 12% (4/33) of the users had evidence of PM compared to 48% (16/33) of nonusers. Among nonusers, 17/33, 8/33, 2/33, and 6/33 had no placental infection, active infection, active-chronic infection, and past-chronic infection, respectively. Among users, respective proportions were 29/33, 2/33, 0/33, and 2/33. No difference in birth weights was apparent between the two groups, probably due to a higher proportion of infections occurring later in pregnancy. Histological evidence here suggests that SP continues to offer substantial benefit as IPTp.
磺胺嘧啶-乙胺嘧啶(SP-IPTp)间歇预防性治疗妊娠期疟疾被广泛用于减少不良妊娠结局的发生率。作为在SP耐药性情况下该干预措施持续有效性的监测,我们旨在评估使用或不使用SP- iptp的孕妇的疟疾负担。在坎帕拉Mulago医院的一项描述性队列研究中,87名接受了两剂SP-IPTp的妇女被随访至分娩。对照组为无SP-IPTp病史的初产孕妇。采用Bulmer分类标准对胎盘疟疾(PM)进行组织病理学检查。87名妇女中有38名返回分娩,33名胎盘被成功收集和处理,还有33名胎盘来自未使用SP的妇女。总体而言,12%(4/33)的用户有PM的证据,而非用户为48%(16/33)。未用药人群中,17/33、8/33、2/33和6/33分别无胎盘感染、活动性感染、活动性慢性感染和既往慢性感染。用户的比例分别为29/33、2/33、0/33、2/33。两组的出生体重没有明显差异,可能是由于怀孕后期感染的比例更高。组织学证据表明,SP继续提供实质性的益处作为IPTp。
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引用次数: 9
Inhibition of In Vivo Growth of Plasmodium berghei by Launaea taraxacifolia and Amaranthus viridis in Mice 蒲公藤和绿苋菜对小鼠体内伯氏疟原虫生长的抑制作用
Q2 Medicine Pub Date : 2016-12-05 DOI: 10.1155/2016/9248024
A. Adetutu, O. S. Olorunnisola, A. O. Owoade, P. Adegbola
Launaea taraxacifolia and Amaranthus viridis used by people of Western Africa in the treatment of malaria and related symptoms were assessed for their antiplasmodial value against the chloroquine sensitive strain of Plasmodium berghei. Crude extracts (200 mg/kg) and chloroquine (5 mg/kg) were administered to different groups of Swiss mice. The percentage of parasitemia, survival time, and haematological parameters were determined. Both extracts significantly (p < 0.05) inhibited parasitemia and improved survival time in infected mice. The crude extracts prevented loss of some haematological parameters. A. viridis had a distinct effect on the packed cell volume. The extract was able to protect the liver from some of the damage. This study however showed that the methanolic extracts of A. viridis and L. taraxacifolia possess antiplasmodial activity. The results of this study can be used as a basis for further phytochemical investigations in the search for new and locally affordable antimalarial agents.
评价了西非人用于治疗疟疾及其相关症状的蒲公英和绿苋苋对伯氏疟原虫氯喹敏感株的抗疟原虫作用。给予不同组瑞士小鼠粗提物(200 mg/kg)和氯喹(5 mg/kg)。测定寄生虫率、生存时间和血液学参数。两种提取物均能显著(p < 0.05)抑制寄生虫血症,延长感染小鼠的存活时间。粗提物防止了一些血液学参数的损失。青霉对堆积的细胞体积有明显的影响。这种提取物能够保护肝脏免受一些损害。本研究表明,青草和蒲公英甲醇提取物具有抗疟原虫活性。这项研究的结果可以作为进一步植物化学研究的基础,以寻找新的和当地负担得起的抗疟疾药物。
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引用次数: 26
Maternal Attitudes about Objectively Monitored Bednet Use in Rural Uganda 乌干达农村孕产妇对客观监测蚊帐使用情况的态度
Q2 Medicine Pub Date : 2016-10-19 DOI: 10.1155/2016/8727131
P. Krezanoski, D. Santorino, Nuriat Nambogo, Jeffrey I. Campbell, D. Bangsberg
Insecticide-treated bednets (ITNs) are a mainstay of malaria prevention, yet poor adherence poses a major barrier to effective prevention. Self-reports of bednet use suffer from recall and social desirability biases. We have designed a device that electronically records ITN usage longitudinally. SmartNet consists of circuits made from a conductive fabric interwoven into the sides and top of a rectangular ITN. Digital sampling of the state of these circuits allows for determining whether the SmartNet is deployed for use or folded up. We conducted a study among pregnant women and women with children <5 years in Uganda to determine attitudes about objective bednet monitoring and SmartNet. Fifty women were interviewed with an average age of 27 years and 2.3 children. Twenty-two percent were pregnant. Ninety-five percent had used a bednet and 90% reported having a bednet at home. After displaying a SmartNet, 92% thought it would be easy to use and 100% expressed interest in using SmartNet. Concerns about SmartNet included washing the net, worries about being monitored while asleep, and worries about users removing the device components. Objective monitoring of ITN use appears to be acceptable among women in rural Uganda, setting the stage for further SmartNet field testing.
驱虫蚊帐(ITNs)是疟疾预防的主要手段,但依从性差是有效预防的主要障碍。使用蚊帐的自我报告受到回忆和社会期望偏差的影响。我们设计了一种可以纵向记录ITN使用情况的电子设备。SmartNet由导电织物制成的电路交织在矩形ITN的侧面和顶部。这些电路状态的数字采样允许确定SmartNet是部署使用还是折叠。我们在乌干达的孕妇和儿童小于5岁的妇女中进行了一项研究,以确定对客观蚊帐监测和SmartNet的态度。50名女性接受了调查,她们的平均年龄为27岁,有2.3个孩子。22%的人怀孕了。95%的人使用过蚊帐,90%的人在家里有蚊帐。在展示SmartNet后,92%的人认为它很容易使用,100%的人表示有兴趣使用SmartNet。对SmartNet的担忧包括洗网,担心在睡觉时被监控,以及担心用户移除设备组件。乌干达农村妇女似乎可以接受对ITN使用情况的客观监测,这为进一步进行SmartNet现场测试奠定了基础。
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引用次数: 10
High Prevalence of Plasmodium falciparum Infection in Asymptomatic Individuals from the Democratic Republic of the Congo 刚果民主共和国无症状个体感染恶性疟原虫的高流行率
Q2 Medicine Pub Date : 2016-01-28 DOI: 10.1155/2016/5405802
D. Mvumbi, T. Bobanga, P. Melin, P. de Mol, J. Kayembe, H. Situakibanza, G. Mvumbi, C. Nsibu, S. Umesumbu, M. Hayette
Malaria remains a major public health problem in the Democratic Republic of Congo (DRC) with 14 million cases reported by the WHO Malaria Report in 2014. Asymptomatic malaria cases are known to be prevalent in endemic areas and are generally untreated, resulting in a significant source of gametocytes that may serve as reservoir of disease transmission. Considering that microscopy certainly underestimates the prevalence of Plasmodium infections within asymptomatic carriers and that PCR assays are currently recognized as the most sensitive methods for Plasmodium identification, this study was conducted to weigh the asymptomatic carriage in DRC by a molecular method. Six provinces were randomly selected for blood collection in which 80 to 100 individuals were included in the study. Five hundred and eighty blood samples were collected and molecular diagnosis was performed. Globally, almost half of the samples collected from asymptomatic individuals (280/580; 48.2%) had Plasmodium infections and the most species identified was P. falciparum alone in combination with P. malariae. The high prevalence reported here should interpellate the bodies involved in malaria control in DR Congo to take into account asymptomatic carriers in actions taken and consider asymptomatic malaria as a major hurdle for malaria elimination.
疟疾仍然是刚果民主共和国的一个主要公共卫生问题,世卫组织2014年疟疾报告报告了1400万例病例。已知无症状疟疾病例在流行地区普遍存在,而且通常未得到治疗,这导致配子体的大量来源可能成为疾病传播的宿主。考虑到显微镜确实低估了无症状携带者中疟原虫感染的流行程度,而PCR检测是目前公认的最敏感的疟原虫鉴定方法,本研究采用分子方法对刚果民主共和国无症状携带者进行称重。随机选择6个省份进行血液采集,其中80 - 100人被纳入研究。采集血样580份,进行分子诊断。在全球范围内,从无症状个体收集的样本中,几乎有一半(280/580;48.2%)有疟原虫感染,其中以恶性疟原虫与疟疾疟原虫合并感染最多。这里报告的高流行率应促使刚果民主共和国参与疟疾控制的机构在采取行动时考虑到无症状携带者,并将无症状疟疾视为消除疟疾的主要障碍。
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引用次数: 33
Assessing ABO/Rh Blood Group Frequency and Association with Asymptomatic Malaria among Blood Donors Attending Arba Minch Blood Bank, South Ethiopia 评估埃塞俄比亚南部Arba Minch血库献血者ABO/Rh血型频率及其与无症状疟疾的关系
Q2 Medicine Pub Date : 2016-01-27 DOI: 10.1155/2016/8043768
Getaneh Alemu, M. Mama
Background. Determination of the various ABO/Rh blood group distributions and their association with malaria infection has paramount importance in the context of transfusion medicine and malaria control. Methods. Facility based cross-sectional study was conducted from February to June, 2015, to assess ABO/Rh blood groups distribution and their association with asymptomatic malaria. A structured questionnaire was used to collect data. Blood grouping was done using monoclonal antibodies. Thin and thick blood films were examined for Plasmodium parasites. Data were analyzed using SPSS version 20.0. Results. A total of 416 blood donors participated with median age of 22 ± 0.29 (median ± standard error of the mean). Distribution of ABO phenotypes, in decreasing order, was O (175, 42.1%), A (136, 32.7%), B (87, 20.9%), and AB (18, 4.3%). Most of them were Rh+ (386, 92.8%). The overall malaria prevalence was 4.1% (17/416). ABO blood group is significantly associated with malaria infection (P = 0.022). High rate of parasitemia was seen in blood group O donors (6.899, P = 0.003) compared to those with other ABO blood groups. Conclusion. Blood groups O and AB phenotypes are the most and the least ABO blood groups, respectively. There is significant association between ABO blood group and asymptomatic malaria parasitemia.
背景。确定各种ABO/Rh血型分布及其与疟疾感染的关系在输血医学和疟疾控制方面具有至关重要的意义。方法。2015年2月至6月进行了基于设施的横断面研究,以评估ABO/Rh血型分布及其与无症状疟疾的关系。采用结构化问卷收集数据。采用单克隆抗体进行血型分型。薄血膜和厚血膜检查疟原虫。数据分析采用SPSS 20.0版本。结果。共有416名献血者参与,年龄中位数为22±0.29岁(中位数±平均标准误差)。ABO表型分布由大到小依次为O型(175,42.1%)、A型(136,32.7%)、B型(87,20.9%)和AB型(18,4.3%)。Rh+最多(386例,92.8%)。疟疾总流行率为4.1%(17/416)。ABO血型与疟疾感染有显著相关性(P = 0.022)。与其他ABO血型相比,O型献血者的寄生虫血症发生率较高(6.899,P = 0.003)。结论。O型和AB型血型分别是ABO血型最多和最少的。ABO血型与无症状疟疾寄生虫病有显著相关性。
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引用次数: 30
Assessing the Role of Climate Change in Malaria Transmission in Africa. 评估气候变化在非洲疟疾传播中的作用。
Q2 Medicine Pub Date : 2016-01-01 Epub Date: 2016-03-15 DOI: 10.1155/2016/7104291
E T Ngarakana-Gwasira, C P Bhunu, M Masocha, E Mashonjowa

The sensitivity of vector borne diseases like malaria to climate continues to raise considerable concern over the implications of climate change on future disease dynamics. The problem of malaria vectors shifting from their traditional locations to invade new zones is of important concern. A mathematical model incorporating rainfall and temperature is constructed to study the transmission dynamics of malaria. The reproduction number obtained is applied to gridded temperature and rainfall datasets for baseline climate and future climate with aid of GIS. As a result of climate change, malaria burden is likely to increase in the tropics, the highland regions, and East Africa and along the northern limit of falciparum malaria. Falciparum malaria will spread into the African highlands; however it is likely to die out at the southern limit of the disease.

疟疾等病媒传播疾病对气候的敏感性继续引起人们对气候变化对未来疾病动态的影响的相当关注。疟疾病媒从其传统地点转移到侵入新的地区的问题是一个重要的问题。为了研究疟疾的传播动力学,建立了考虑降雨量和温度的数学模型。在GIS的帮助下,将获得的复制数应用于基线气候和未来气候的网格化温度和降雨数据集。由于气候变化,热带地区、高地地区、东非以及沿恶性疟疾北部边界的疟疾负担可能会增加。恶性疟疾将蔓延到非洲高地;然而,它很可能在疾病的南部边界灭绝。
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引用次数: 48
期刊
Malaria Research and Treatment
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