尼日利亚某三级医院护理人员病媒控制方法及其对发热儿童疟疾感染的影响

E. Nwaneli
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摘要

背景:疟疾是撒哈拉以南非洲的一个主要公共卫生问题。正在作出若干努力,以减少尼日利亚儿童的流行率和发病率,并着重采取病媒控制措施。方法:这是横断面描述性研究进行了382发烧儿童看到在三级医院在尼日利亚8个月期间。采用结构化问卷收集有关社会人口学、病媒控制措施和对受试者的护理的信息。调查包括疟疾显微镜和总白细胞计数。结果:80%(308/382)的医院采取了至少一种病媒控制措施预防疟疾感染,多数(75.2%)的医院仅采取了一种控制措施。使用的最常见控制措施包括始终关闭门窗298例(96.7%)和/或蚊帐280例(90.9%),使用常规杀虫剂喷雾183例(59.4%),使用经杀虫剂处理的蚊帐178例(57.8%),以及确保儿童夜间睡眠时身体得到充分覆盖77例(25%)。大约一半(178/315)拥有ITN的家庭使用它,只有40.4%(72/178)每天使用它。注意到,睡在杀虫剂处理过的蚊帐下的儿童(相对危险度0.56,95%可信区间0.33-0.94;P=0.029)和夜间睡得好的人(RR 0.26, 95% CI 0.12-0.61;P=0.002)感染疟疾的风险较低。然而,在调整了其他控制措施和社会人口因素后,使用杀虫剂处理过的蚊帐失去了显著性(RR 0.63, 95% CI 0.36-1.10;P=0.101)。结论:应加强疟疾防治措施教育,特别是夜间睡眠时应正确使用驱虫蚊帐和穿着。
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Caregivers’ vector control methods and its effect on malaria infection in febrile children presenting in a Tertiary Hospital in Nigeria
Background: Malaria is a major public health problem in sub-Saharan Africa. Several efforts are being made to reduce its prevalence and morbidity in Nigerian children with emphasison vector control measures.Methods: This was acrosssectional descriptive study conducted on 382 febrile children seen at a tertiary hospital in Nigeria over an eight-month period. A structured questionnaire was used to collect information on sociodemographic, vector control measures and care given to the subjects. Investigations conducted included malaria microscopy and total leukocyte count.Results: Eighty percent (308/382) employed at least one vector controlmeasures to prevent malaria infection, and majority 232 (75.2%) use only one control measure. The commonest control measures used included always keeping doors and windows shut 298 (96.7%) and/or netted 280 (90.9%), use of conventional insecticide sprays 183 (59.4%), use of insecticide treated bed nets (ITNs) 178 (57.8%) and ensuring child sleeps at night with body adequately covered 77(25%). Approximately half (178/315) of households who owned ITN used it, and only 40.4% (72/178) used it daily. It was noted that children that slept under an insecticide treated bed net (RR 0.56, 95% CI 0.33-0.94; P=0.029) and those who slept well covered at night (RR 0.26, 95% CI 0.12-0.61; P=0.002) had less risk of malaria infection. The use insecticide treated bed net however lost significance following adjustment for other control measures used and socio-demographic factors of interest (RR 0.63, 95% CI 0.36-1.10;P=0.101).Conclusion: There is need to intensify education on appropriate malaria control measures especially proper use of insecticide-treated nets and suitable clothing during sleep at night.
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