Increase in malaria prevalence and age of at risk population in different areas of Gabon

• Published in: Malaria Journal
• Main Authors: Mawili-Mboumba Denise P, Akotet Marielle K Bouyou, Kendjo Eric, Nzamba Joseph, Medang Mathieu Owono, Mbina Jean-Romain Mourou, Kombila Maryvonne
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2013
• Subjects: Plasmodium falciparum; Children; Fever; Age; Gabon; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic; Melen
• Online Access: https://doi.org/10.1186/1475-2875-12-3; https://doaj.org/article/6d57b6cae8a944039a1d41b74d2bb589

Abstract Background Following the deployment of new recommendations for malaria control according to the World Health Organization, an estimation of the real burden of the disease is needed to better identify populations at risk and to adapt control strategies. The aim of the present study was to estimate the clinical burden of malaria among febrile children aged less than 11 years, before and after six-year of deployment of malaria control strategies in different areas of Gabon. Methods Cross-sectional surveys were carried out in health care facilities at four locations: two urban areas (Libreville and Port-Gentil), one semi-urban area (Melen) and one rural area (Oyem), between 2005 and 2011. Febrile paediatric patients, aged less than 11 years old were screened for malaria using microscopy. Body temperature, history of fever, age, sex, and location were collected. Results A total of 16,831 febrile children were enrolled; 78.5% (n=13,212) were less than five years old. The rate of Plasmodium falciparum -infection was the lowest in Port-gentil (below 10%) and the highest at Oyem (above 35%). Between 2005 and 2008, malaria prevalence dropped significantly from 31.2% to 18.3%, followed by an increase in 2011 in Libreville (24.1%), Port-Gentil (6.5%) and Oyem (44.2%) ( p <0.01). Median age among the infected patients increased throughout the study period reaching 84 (60–108) months in Libreville in 2011 ( p <0.01). From 2008, at all sites, children older than five years were more frequently infected; the risk of being infected significantly increased with time, ranging from 0.37 to 1.50 in 2005 and from 2.03 to 5.10 in 2011 in this group ( p< 0.01). The risk of being P. falciparum -infected in children aged less than five years old significantly decreased from 2008 to 2011 ( p <0.01). Conclusions This study shows an increased risk of malaria infection in different areas of Gabon with over-five year-old children tending to become the most at-risk population, suggesting a changing epidemiology. Moreover, ...