疟疾危险因素的Meta分析

中国寄生虫学与寄生虫病杂志 ›› 2017, Vol. 35 ›› Issue (6): 594-597.

疟疾危险因素的Meta分析

曾旭灿, 罗春海, 林祖锐, 周子悠, 吕全, 周兴武, 李建雄, 周耀武, 孙晓东^*()

云南省寄生虫病防治所,云南省虫媒传染病防控研究重点实验室,云南省疟疾研究中心,云南公共卫生与疾病防控协同创新中心,普洱665000

收稿日期:2017-11-27 出版日期:2017-12-30 发布日期:2018-01-10
通讯作者: 孙晓东
基金资助:
云南省中青年学术技术带头人后备人才项目（No.2015HB075）

Risk factors for malaria: a Meta-analysis

Xu-can ZENG, Chun-hai LUO, Zu-rui LIN, Zi-you ZHOU, Quan LV, Xing-wu ZHOU, Jian-xiong LI, Yao-wu ZHOU, Xiao-dong SUN^*()

Yunnan Provincial Key Laboratory of Vector-borne Disease Control and Research,Yunnan Provincial Center of Malaria Research, Yunnan Provincial Collaborative Innovation Center for Public Health and Disease Prevention and Control, Yunnan Institute of Parasitic Diseases, Pu’er 665000, China

Received:2017-11-27 Online:2017-12-30 Published:2018-01-10
Contact: Xiao-dong SUN
Supported by:
Supported by the Candidates Project of the Young and Middle Aged Academic Leaders of Yunnan Province(No. 2015HB075)

摘要/Abstract

摘要：

为分析疟疾发病的相关危险因素,采用Meta分析方法,通过检索 PubMed、中国期刊全文数据库（CNKI）、EMbase、Cochrane等中英文数据库,并辅以手工检索、文献追溯等方法,收集国内外1990-2016年公开发表的关于疟疾发病危险因素的相关文献,计算各因素合并比值比（OR）和95%可信区间（95%CI）,采用RevMan 5.2软件进行统计学分析。结果共纳入18篇文献,累计疟疾病例3 509例,对照12 447人。Meta分析结果显示,很少或从不使用蚊帐、临时性的房屋结构、发病前1个月内到过疟疾流行区、过去1年中家中或四邻有疟疾病例等因素的合并OR（95%CI）分别为1.62（1.42,1.85）、1.57（1.09,2.28）、2.88（2.00,4.16）、3.59（2.93,4.40）,均具有统计学意义（P < 0.05）,为危险因素。提示在今后的疟疾防治中应重点关注患者周围人群和有流行病学史的患者,以及加强个人防护等的卫生宣教。

关键词: 疟疾, 危险因素, Meta分析

Abstract:

To analyze the risk factors for malaria, case-control studies on malaria risk factors from 1990 to 2016 were collected from databases of PubMed, CNKI, EMbase and Cochrane.The odds ratio (OR) and 95% confidence interval (95%CI) were calculated for each factor.Meta-analysis was performed with the RevMan 5.2 software.Eighteen case-control studies involving 3 509 cases and 12 447 controls were finally included for the analysis.Meta-analysis results revealed risk factors of never or rarely using a mosquito net, housing structure for the temporary use, exposure to the endemic areas 1 month before malaria onset, malaria occurrence in family members or neighborhood in the past year, with pooled OR values (95%CI) of 1.62 (1.42,1.85), 1.57 (1.09,2.28), 2.88 (2.00,4.16), and 3.59 (2.93,4.40), respectively (all P < 0.05).The results suggest the importance of paying attention to populations who have contacts with patients and those with an epidemiological history, and strengthenting the health education of personal protection and so on.

Key words: Malaria, Risk factor, Meta analysis

中图分类号:

R531.3

曾旭灿, 罗春海, 林祖锐, 周子悠, 吕全, 周兴武, 李建雄, 周耀武, 孙晓东. 疟疾危险因素的Meta分析[J]. 中国寄生虫学与寄生虫病杂志, 2017, 35(6): 594-597.

Xu-can ZENG, Chun-hai LUO, Zu-rui LIN, Zi-you ZHOU, Quan LV, Xing-wu ZHOU, Jian-xiong LI, Yao-wu ZHOU, Xiao-dong SUN. Risk factors for malaria: a Meta-analysis[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2017, 35(6): 594-597.

图/表 3

参考文献 30

[1]	丰俊, 夏志贵.2004~2013年中国疟疾发病情况及趋势分析[J].中国病原生物学杂志, 2014, 9(5): 442-446.
[2]	张再兴, 孙晓东, 杨亚明, 等.云南西双版纳疟疾暴发区疟疾发病危险因素的病例对照调查(英文)[J].中国寄生虫病防治杂志, 2002, 15(1): 12-15.
[3]	张瑜.云南边境地区疟疾感染危险因素病例对照研究[D].大理: 大理学院, 2013.
[4]	Xu JW, Liu H, Zhang Y, et al. Risk factors for border malaria in a malaria elimination setting: a retrospective case-control study in Yunnan, China[J].Am J Trop Med Hyg 2015, 92(3): 546-551.
[5]	Wotodjo AN, Diagne N, Gaudart J, et al. Malaria risk factors in Dielmo, a Senegalese malaria-endemic village, between October and November of 2013: a case-control study[J].Am J Trop Med Hyg, 2015, 92(3): 565-568.
[6]	Mugwagwa N, Mberikunashe J, Gombe NT, et al. Factors associated with malaria infection in Honde valley, Mutasa district, Zimbabwe, 2014: a case control study[J].BMC Res Notes, 2015, 8: 829.
[7]	Lichtenstein MJ, Mulrow CD, Elwood PC, et al. Guidelines for reading case-control studies[J].J Chronic Dis, 1987, 40(9): 893-903.
[8]	邓鹏, 杨颖, 林健东, 等.手足口病危险因素的meta分析[J].中华疾病控制杂志, 2013, 17(4): 310-313.
[9]	Wynder EL, Higgins IT, Harris RE.The wish bias[J].J Clin Epidemiol, 1990, 43(6): 619-621.
[10]	赵风源, 贺圣文, 赵仁宏, 等.胃癌危险因素的Meta分析[J].中国卫生统计, 2010, 27(2): 146-148.
[11]	谢海瑞, 胡罡, 沈二霞, 等.儿童哮喘危险因素的Meta分析及归因危险度百分比的探讨[J].中国妇幼保健, 2013, 28(25): 4143-4146.
[12]	Danis-Lozano R, Rodriguez MH, Gonzalez-Ceron L, et al. Risk factors for Plasmodium vivax infection in the Lacandon forest, southern Mexico[J].Epidemiol Infect, 1999, 122(3): 461-469.
[13]	Roosihermiatie B, Nishiyama M, Nakae K.The human behavioral and socioeconomic determinants of malaria in Bacan Island, North Maluku, Indonesia[J].J Epidemiol, 2000, 10(4): 280-289.
[14]	Osorio L, Todd J, Bradley DJ.Travel histories as risk factors in the analysis of urban malaria in Colombia[J].Am J Trop Med Hyg, 2004, 71(4): 380-386.
[15]	Danis-Lozano R, Rodriguez MH, Betanzos-Reyes AF, et al. Individual risk factors for Plasmodium vivax infection in the residual malaria transmission focus of Oaxaca, Mexico[J].Salud Publica Mex, 2007, 49(3): 199-209.
[16]	Sharma PK, Ramanchandran R, Hutin YJ, et al. A malaria outbreak in Naxalbari, Darjeeling district, West Bengal, India, 2005: weaknesses in disease control, important risk factors[J].Malar J, 2009, 8: 288.
[17]	Leslie T, Briceno M, Mayan I, et al. The impact of phenotypic and genotypic G6PD deficiency on risk of Plasmodium vivax infection: a case-control study amongst Afghan refugees in Pakistan[J].PLoS Med, 2010, 7(5): e1000283.
[18]	Siri JG, Wilson ML, Murray S, et al. Significance of travel to rural areas as a risk factor for malarial anemia in an urban setting[J].Am J Trop Med Hyg, 2010, 82(3): 391-397.
[19]	朱东山, 葛军, 朱刚, 等.疟区1 508例发热病人流行病学特征分析[J].现代预防医学, 2013, 40(9): 1607-1610.
[20]	Okebe J, Mwesigwa J, Kama EL, et al. A comparative case control study of the determinants of clinical malaria in The Gambia[J].Malar J, 2014, 13: 306.
[21]	何昌华, 王善青, 胡锡敏, 等.上山作业人群疟疾抗体阳性KAP影响因素分析[J].中国公共卫生, 2014, 30(1): 91-94.
[22]	Lynch CA, Bruce J, Bhasin A, et al. Association between recent internal travel and malaria in Ugandan highland and highland fringe areas[J].Trop Med Int Health, 2015, 20(6): 773-780.
[23]	Rosas-Aguirre A, Ponce OJ, Carrasco-Escobar G, et al.Plasmodium vivax malaria at households: spatial clustering and risk factors in a low endemicity urban area of the northwestern Peruvian coast[J].Malar J, 2015, 14: 176.
[24]	Damien GB, Djenontin A, Chaffa E, et al. Effectiveness of insecticidal nets on uncomplicated clinical malaria: a case-control study for operational evaluation[J].Malar J, 2016, 15: 102.
[25]	李丽, 张再兴, 周升, 等.湄公河流域居民住房结构与疟疾患病情况分析[J].中国热带医学, 2008, 8(2): 270-271.
[26]	张丽, 周水森, 丰俊, 等.2015年全国疟疾疫情分析[J].中国寄生虫学与寄生虫病杂志, 2016, 34(6): 477-481.
[27]	闫润泽, 周水森, 夏志贵, 等.我国疟疾传播时空分布特征分析[J].中国病原生物学杂志, 2014,9(3): 198-202+219.
[28]	李鹏生, 樊大宏.1999-2003年云南省腾冲县3 646例疟疾分析[J].寄生虫病与感染性疾病, 2005, 3(1): 29-30.
[29]	Delacollette C,D'Souza C,Christophel E, et al.Malaria trends and challenges in the Greater Mekong Subregion.Southeast Asian[J].J Trop Med Public Health, 2009, 40(4): 674-691.
[30]	王冬梅, 陈勃江, 李为民, 等.肺癌危险因素的Meta分析[J].中国循证医学杂志, 2010, 10(12): 1446-1449.

发病因素	纳入研究文献	效应模型	合并OR 值（95%CI）
很少或从不使用蚊帐	[2, 3, 12, 13, 15, 16, 19, 20, 23, 24]	固定	1.62（1.42,1.85）^a
性别（男性）	[2, 4-6, 13, 16, 17, 24]	固定	1.07（0.93,1.22）^b
未采取其他防蚊措施	[4-6, 12-14, 16, 18, 19, 21, 24]	随机	1.50（0.99,2.25）^b
临时性的房屋结构	[4, 13, 15, 18, 21, 23]	随机	1.57（1.09,2.28）^a
发病前1个月内到过疟疾流行区	[4, 5, 13, 15, 22]	固定	2.88（2.00,4.16）^a
过去1年中家中或四邻有疟疾病例	[13-15, 19]	固定	3.59（2.93,4.40）^a
未受过教育	[3, 6, 13, 20, 23]	随机	1.33（0.88,2.02）^b
年龄≤ 5 岁	[6, 13, 14, 20]	随机	1.67（0.82,3.39）^b