Background: According to the World Health Organization, there were more than 228 million cases of malaria globally in 2018, with 93% of cases occurring in Africa; in Mali, a 13% increase in the number of cases was observed between 2015 and 2018; this study aimed to evaluate the impact of meteorological and environmental factors on the geo-epidemiology of malaria in the health district of Dire, Mali. Methods: Meteorological and environmental variables were synthesized using principal component analysis and multiple correspondence analysis, the relationship between malaria incidence and synthetic indicators was determined using a multivariate general additive model; hotspots were detected by SaTScan. Results: Malaria incidence showed high inter and intra-annual variability; the period of high transmission lasted from September to February; health areas characterized by proximity to the river, propensity for flooding and high agricultural yield were the most at risk, with an incidence rate ratio of 2.21 with confidence intervals (95% CI: 1.85–2.58); malaria incidence in Dire declined from 120 to 20 cases per 10,000 person-weeks between 2013 and 2017. Conclusion: The identification of areas and periods of high transmission can help improve malaria control strategies.

中文翻译：

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卫生区一级疟疾地理流行病学，马里迪雷卫生区，2013-2017 年。


背景：根据世界卫生组织的数据，2018年全球有超过2.28亿例疟疾病例，其中93%的病例发生在非洲；在马里，2015 年至 2018 年间病例数量增加了 13%；本研究旨在评估气象和环境因素对马里德雷卫生区疟疾地理流行病学的影响。方法：采用主成分分析和多重对应分析综合气象和环境变量，采用多元一般相加模型确定疟疾发病率与综合指标之间的关系； SaTScan 检测到热点。结果：疟疾发病率表现出较高的年际和年内变异性；高传播期为9月至2月；以靠近河流、易发生洪水和农业高产为特征的卫生区域面临的风险最大，其发病率为 2.21，置信区间为（95% CI：1.85-2.58）； 2013 年至 2017 年间，德雷的疟疾发病率从每万人周 120 例下降到 20 例。结论：确定高传播区域和时期有助于改进疟疾控制策略。