Le paludisme de l'enfant à Kinshasa (Zaïre); influence des saisons, de l'âge, de l'environnement et du standing familial

Childhood malaria in Kinshasa (Zaire). Influence of seasons, age, environment, and family social conditions: Frequency of malaria in children was evaluated from march 1986 to February 1987 in six districts of Kinshasa by paludometric survey with multiple visits. The six districts were selected according to their geographical situation and their degree of urbanisation. Each month, two stocks of children from 0 to 10 years old dwelling in a street were selected district and visited twice randomization in each selected district and visited twice at 2 weeks of interval. 5,541 children were examined at the occasion of the second visit. Influence of seasons, age, district, socio-economic level of the family and level of education of the parents was determined by analysing the following parameters: plasmodial index, parasitic density, incidence of fever attacks, conversion rate of thick smear, antimalaria drug consumption. Parasitic prevalence is 50 p.c. annual incidence of fever attacks is 50 p.c. and annual frequency of antimalaria drugs is 3,64 per child. Dry seasons (June-September and January-February) ease the pathophoresis and pathogenicity of plasmodia. The age group of less than one year is relatively less parasitized but from 2 years, contact with parasites is very high and without any significant evolution up to 10 years. The district where a child is living plays a predominant role on paludometric indices. Transmission is deeply influenced by geographical situation in the center of the town or in outlying districts and by the socio-economic environment (basic equipment, streets conditions, quality of accommodation). The socio-economic level of the child's family is also important in regard to malaria prevention. The level of education of the parents and mainly the mother has the greatest influence