Prevalência da Parasitemia da malária na Guiné-Bissau: Comparação entre faixas etárias, regiões Sanitárias, e zonas Urbanas e Rurais

Abstract

Context: Over the last years, several strategies to fight malaria have been implemented in Guinea-Bissau. Nevertheless, this disease continues to represent severe public health concern. In fact, malaria remains the first cause of morbidity and mortality among children younger than five years of age, being responsible for most hospital admissions and deaths in that age group. This reflects the persistence of transmission and the challenges faced by the healthcare system in controlling this disease. Characterizing the epidemiological situation of malaria in Guinea-Bissau is key to design effective strategies for controlling this disease. Objective: To Evaluate the prevalence of malaria parasitemia in Guinea-Bissau, comparing it in relation to participants' sex, age group, geographic region and urbanization pattern. In addition, this work aims to evaluate which of these factors are associated with the prevalence of the disease. Methods: This is an analysis of the data of the Inquérito de Indicadores Múltiplos de Malária (MIS 2023). This is an observational cross-sectional study that has been performed in 2023 throughout all regions of Guinea-Bissau. Individuals aged at least six months and living in Guinea-Bissau were eligible to participate. Participants were selected though a cluster sampling approach. A rapid diagnosis test (RDT) was used to evaluate malaria parasitemia. Prevalences were estimated using descriptive methods, while the associations with demographic and socioeconomic variables were evaluated by means of logistic regression. Results of those models were presented as crude and adjusted odds ratio with 95% confidence intervals. Results: Among the 10,417 tested participants, 412 (4% [95%CI:3%-4%]) displayed positive results in RDT, with that corresponding to the prevalence of malaria. The prevalence of malaria was higher in males 173 (4.2% [95%CI:3%-4%]), school-aged children (7.5% [IC95%:5%-9%]), participants from the Gabu region (13.4% [95%CI:11%-14%]), and low-income individuals (4.9% [95%CI:4%-6%]). In univariable logistic regression models, the geographical region was the variable with the strongest association with the prevalence of malaria (OR for the Gabu region versus the remainder =7.018 [95%CI:6%-9%] p<0,001). These results were consistent with those obtained in a multivariable logistic regression model, in which age, the socio-economic index and urbanization pattern were also significantly associated with the occurrence of malaria. Conclusion: This study demonstrates a prevalence of 4% of malaria parasitemia, with variability according to the zones and geographical regions. A higher prevalence was found in school-aged children, lower income individuals and participants with no schooling.