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Towards an actionable One Health approach

贫困所致传染病(英文) 2024年第2期13卷 77-82页

作者： Zhang Xiao-Xi Lederman Zohar Han Le-Fei Schurer Janna M. Xiao Li-Hua Zhang Zhi-Bing Chen Qiu-Lan Pfeiffer Dirk Ward Michael P. Sripa Banchob Gabri?l Sarah Dhama Kuldeep Acharya Krishna Prasad Robertson Lucy J. Deem Sharon L. Aenishaenslin Cécile Dantas-Torres Filipe Otranto Domenico Grace Delia Wang Yang Li Peng Fu Chao Poeta Patrícia Rahman Md. Tanvir Kassegne Kokouvi Zhu Yong-Zhang Yin Kun Liu Jiming Wang Zhao-Jun Guo Xiao-Kui Gong Wen-Feng Schwartl?nder Bernhard Ren Ming-Hui Zhou Xiao-Nong Sydney School of veterinary Science The University of Sydney Camden Australia Tropical Disease Research Center Department of Tropical Medicine Faculty of Medicine Khon Kaen University Khon Kaen Thailand Laboratory of foodborne parasitic zoonoses Department of translational physiology infectiology and public health Chair Faculty Committee on Internationalisation Faculty of Veterinary Medicine Ghent University Merelbeke Belgium Division of Pathology ICAR-Indian Veterinary Research Institute (IVRI) Bareilly Uttar Pradesh India Department of Livestock Services Animal Quarantine Office-Kathmandu Budhanilkantha Kathmandu Nepal Parasitology Department of Paraclinical Sciences Faculty of Veterinary Medicine Norwegian University of Life Sciences ?s Norway One Government Drive Saint Louis Zoo Institute for Conservation Medicine St. Louis USA Groupe de Recherche en épidémiologie des Zoonoses et Santé Publique (GREZOSP) Faculté de médecine vétérinaire Université de Montréal Saint-Hyacinthe Québec Canada Centre de recherche en santé publique de l Université de Montréal et du CIUSSS du Centre-Sud-de-l’?le-de-Montréal Montréal Québec Canada Department of Immunology Aggeu Magalh?es Institute Oswaldo Cruz Foundation (Fiocruz) Recife Brazil School of Global Health Chinese Center for Tropical Diseases Research Shanghai Jiao Tong University School of Medicine Shanghai People’s Republic of China Department of veterinary Medicine University of Bari Valenzano Italy Department of Pathobiology Faculty of Veterinary Science Bu-Ali Sina University Hamedan Iran Natural Resources Institute University of Greenwich Chatham Maritime UK International Livestock Research Institute Nairobi Kenya Director of Key Laboratory of Animal Antimicrobial Resistance Surveillance Ministry of Agriculture and Rural Affairs Beijing People’s Republic of China Institute of Animal Science Chinese Academy of Agricultural Sciences Beijing People’s Republic of China Key Laboratory of Ecosystem Network O

Background Despite the increasing focus on strengthening One Health capacity building on global level, challenges remain in devising and implementing real-world interventions particularly in the Asia-Pacific region. Recognizing these gaps, the One Health Action Commission (OHAC) was established as an academic community for One Health action with an emphasis on research agenda setting to identify actions for highest *** text This viewpoint describes the agenda of, and motivation for, the recently formed OHAC. Recognizing the urgent need for evidence to support the formulation of necessary action plans, OHAC advocates the adoption of both bottom-up and top-down approaches to identify the current gaps in combating zoonoses, antimicrobial resistance, addressing food safety, and to enhance capacity building for context-sensitive One Health *** By promoting broader engagement and connection of multidisciplinary stakeholders, OHAC envisions a collaborative global platform for the generation of innovative One Health knowledge, distilled practical experience and actionable policy advice, guided by strong ethical principles of One Health.

关键词： One Health Global Health One Health Action Commission Research agenda

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First survey of hard ticks(Acari: Ixodidae) on cattle, sheep and goats in Boeen Zahra and Takistan counties, Iran

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Asian Pacific Journal of Tropical Biomedicine 2012年第6期2卷 489-492页

作者： Masoomeh Shemshad Khadijeh Shemshad Mohammad Mehdi Sedaghat Majid Shokri Alireza Barmaki Mojgan Baniardalani Javad Rafinejad Department of Agricultural Extension and Education Science and Research Branch Islamic Azad University Department of Entomology Science and Research Branch Islamic Azad University Department of Medical Entomology and Vector control School of Public Health Tehran University of Medical Sciences parasitic and protozoan diseases control office qazvin veterinary organization Department of Medical Entomology and Vector control Health Center of Takistan County Evaluation Management and Development Center Deputy of Research Ministry of Health and Medical Education

Objective:To carry out the distribution survey of hard ticks of livestock in Boeen Zahra and Takistan counties of qazvin province from April 2010 to September ***:Nearly about 2638 sheep, 461 goats and 318 cattle of 38 herds in different geographical areas were searched for tick ***:The species compositions collected from the livestock of Boeen Zahra and Takistan wereHaemaphysalis concinna(0.63%),Haemaphysalis sulcata(12.66%),Hyalomma anatolicum(3.80%),Hyalomma asiaticum(3.16%),Hyalomma detritum(5.70%),Hyalomma dromedarii(28.48%),Hyalomma marginatum(13.29%),Hyalomma schulzei(1.89%),Rhipicephalus bursa(3.16%) and Rhipicephalus sanguineus(3.16%), and for Takistan's livestock were Hyalomma dromedarii(9.86%),Hyalomma marginatum(13.29%),Hyalomma schulzei(1.89%) and Rhipicephalus sanguineus(3.16%), respectively. Hard ticks compositions in different topographic areas were *** had the most prevalence in the ***:The veterinary and public health investigation of the above species should be taken.

关键词： Hard ticks Ixodidae Cattle Sheep Goats Boeen Zahra Takistan Iran

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Urgent needs in fostering neglected tropical diseases(NTDs)laboratory capacity in WHO Western Pacific Region:results from the external quality assessment on NTDs diagnosis in 2012-2015

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Infectious diseases of Poverty 2017年第1期6卷 955-962页

作者： Yan Lu Glenda Gonzales Shao-Hong Chen Hao Li Yu-Chun Cai Yan-Hong Chu Lin Ai Mu-Xin Chen Hai-Ning Chen Jia-Xu Chen National Institute of parasitic diseases Chinese Center for Disease Control and PreventionKey Laboratory of Parasite and Vector BiologyMinistry of HealthWHO Collaborating Center for Tropical Diseases207 Ruijin Er RdShanghai 200025People’s Republic of China Malaria Other Vector borne and Parasitic Diseases(MVP)unitthe World Health Organization Regional Office for the Western PacificP.O.Box 29321000 ManilaPhilippines National Institute of parasitic diseases Chinese Center for Diseases Control and Prevention207 Ruijin Er RdShanghai 200025China

Background:Neglected tropical diseases(NTDs)are a heterogeneous group of mainly chronic,debilitating and often stigmatizing diseases that largely affects low-income and politically marginalized populations,causing a large burden of public health,social and economies in the NTDs endemic *** are caused by infections with a range of pathogen,including bacteria,parasites,protozoa and *** accurate diagnosis of NTDs is important for reducing morbidity,preventing mortality and for monitoring of control *** Quality Assessment(EQA),a component of laboratory quality assurance,aims to assess the performance of participating laboratories in detecting parasitic *** aim of this paper is to report the findings and put forward the recommendations on capacity build from the EQA results of participating NTDs laboratories in selected countries in the WHO Western Pacific Region from 2012 to ***:Reference or public health laboratories at national level working on NTDs in 6 countries participated in EQAs organized by the National Institute of parasitic diseases(NIPD)of Chinese Center for Disease control and Prevention(CDC)based in Shanghai,*** representatives of each participating laboratory were invited to NIPD to detect NTDs’parasitic infections using the same prepared samples for serological tests(IHA and ELISA)and helminth eggs’morphological tests(Direct smear and Kato-Katz).All of the results were scored and analyzed by using SPSS statistics 19.0 ***:The percentage of participants who had EQA score≥60 during 2012-2015 for direct smear test were 80.00%(2012),71.43%(2013),100%(2014)and 75.00%(2015),whereas for Kato-Katz test were 80.00%(2012),57.14%(2013),100%(2014)and 37.50%(2015),*** detection rate of helminth eggs varied in different species,with Ascaris lumbricoides being the highest at 94.07%in *** laboratories did very well with ELISA tests as shown by the high scores in all four years e

关键词： Neglected tropical diseases Diagnosis External quality assessment Western Pacific Region

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Lessons on malaria control in the ethnic minority regions in Northern Myanmar along the China border, 2007–2014

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Infectious diseases of Poverty 2016年第1期5卷 868-878页

作者： Ru-Bo Wang Jia-Qiang Dong Zhi-Gui Xia Tao Cai Qing-Feng Zhang Yao Zhang Yang-Hui Tian Xiao-Ying Sun Guang-Yun Zhang Qing-Pu Li Xiao-Yu Xu Jia-Yin Li Jun Zhang National Institute of parasitic diseases Chinese Center for Disease Control and PreventionWHO Collaborative Center forTropical DiseasesKey Laboratory of Parasite and Vector BiologyMinistry of HealthShanghai 200025China Yunnan Representative office Health Poverty Action(UK)Kunming 650020China

Background:For many countries where malaria is endemic,the burden of malaria is high in border *** ethnic minority areas along the Myanmar-China border,residents have poor access to medical care for diagnosis and treatment,and there have been many malaria outbreaks in such *** 2007,with the support of the Global Fund to Fight AIDS,Tuberculosis and Malaria(GFATM),a malaria control project was introduced to reduce the malaria burden in several ethnic minority ***:A malaria control network was established during the period from 2007 to *** malaria interventions,including diagnosis,treatment,distribution of LLINs and health education,were conducted to improve the accessibility and quality of malaria control services for local *** cross-sectional surveys were conducted to evaluate intervention coverage and indicators of malaria ***:In ethnic minority regions where a malaria control network was established,both the annual malaria incidence(19.1 per thousand per year,in 2009;8.7,in 2014)and malaria prevalence(13.6%in 2008;0.43%in 2014)decreased dramatically during the past 5–6 years.A total of 851393 febrile patients were detected,202598 malaria cases(including confirmed cases and suspected cases)were treated,and 759574 LLINs were delivered to populations at *** households in 2012,73.9%had at least one ITNs/LLINs(vs.28.3%,in 2008),and 50.7%of children less than 5 years and 50.3%of pregnant women slept under LLINs the night prior to their ***,malaria knowledge was improved in 68.4%of ***:There has been great success in improving malaria control in these regions from 2007 to *** burdens have decreased,especially in KOK and *** continued maintenance of sustainable malaria control networks in these regions may be a long-term process,due to regional conflicts and the lack of funds,technology,and health ***,information and scientific support from the

关键词： Malaria control Ethnic minority regions Northern Myanmar

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From control to elimination:a spatial-temporal analysis of malaria along the China-Myanmar border

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Infectious diseases of Poverty 2020年第6期9卷 63-75页

作者： Fang Huang Li Zhang Jing-Bo Xue Hong-Ning Zhou Aung Thi Jun Zhang Shui-Sen Zhou Zhi-Gui Xia Xiao-Nong Zhou National Institute of parasitic diseases Chinese Center for Disease Control and PreventionChinese Center for Tropical Diseases ResearchWHO Collaborating Center for Tropical DiseasesNational Centre for International Research on Tropical DiseasesMinistry of Science and TechnologyKey Laboratory of Parasite and Vector BiologyMinistry of HealthShanghai200025China Yunnan Institute of parasitic diseases Puer665000China Department of Public Health Ministry of Health and SportsNay Pyi Taw15011Myanmar Health Poverty Action East Asia Programme office Kunming650000China

Background: Malaria cases have declined significantly along the China-Myanmar border in the past 10 years and this region is going through a process from control to *** aim of this study is to investigate the epidemiology of malaria along the border,will identify challenges in the progress from control to ***:: National reported malaria cases from China and Myanmar,along with the data of 18 Chinese border counties and 23 townships in Myanmar were obtained from a web-based diseases information reporting system in China and the national malaria control program of Myanmar,*** data was analyzed,including the number of reported cases,annual parasite index and proportion of vivax *** mapping of the annual parasite index(API)at county or township level in 2014 and 2018 was performed by *** relationship of malaria endemicity on both sides of the border was evaluated by regression ***: The number of reported malaria cases and API declined in the border counties or *** 2014,392 malaria cases were reported from 18 Chinese border counties,including 8.4%indigenous cases and 91.6%imported cases,while the highest API(0.11)was occurred in Yingjiang *** have been no indigenous cases reported since 2017,but 164 imported cases were reported in 2018 and 97.6%were imported from *** average API in 2014 in 23 Myanmar townships was significantly greater than that of 18 Chinese counties(P*** vivax was the predominant species along the *** number of reported malaria cases and the proportion of vivax infection in the 18 Chinese counties were strongly correlated with those of the 23 Myanmar townships(P<0.05).Conclusions: Malaria elimination

关键词： Malaria control Elimination China–Myanmar border

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Investigation and control of a Plasmodium falciparum malaria outbreak in Shan Special Region II of Myanmar along the China-Myanmar Border from June to December 2014

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Infectious diseases of Poverty 2016年第1期5卷 277-287页

作者： Hui Liu Jian-Wei Xu Heng-Lin Yang Mei Li Cheng-De Sun Yi-Jie Yin Zhi-Liang Zheng Guang-Yun Zhang Ai-Shui Yu Yong-Hui Yang Chun-Hui Li Shui Ai Yunnan Institute of parasitic diseases Yunnan Provincial Center of Malaria ResearchYunnan Provincial Collaborative Innovation Center for Public Health and Disease Prevention and ControlYunnan Provincial Key Laboratory of Vector-borne Diseases Control and ResearchPuer 665000China National Institute of parasitic diseases Chinese Center for Disease Control and PreventionShanghai 200025China Wa State Department of Health PangsangShan Special Region IIMyanmar Wa State office of Health Poverty Action PangsangShan Special Region IIMyanmar Menglian Center for Disease control and Prevention Menglian 665800China Wa State Center for Disease control and Prevention PangsangShan Special Region IIMyanmar

Background:From 2007 to 2013,intensive control measures reduced malaria burden by 90%along the China-Myanmar ***,despite these measures a *** malaria outbreak was reported in the Shan Special Region II of Myanmar in June of ***:Epidemiological,parasitological and entomological investigations were *** piperaquine(DAPQ)was immediately administered to treat parasite positive *** lasting insecticidal nets(LLIN),indoor residual spraying(IRS)with insecticides and behavior change communication(BCC)were also provided for outbreak *** embedded efficacy study was conducted evaluating *** genotyping via polymerase chain reaction(PCR)was performed on the Kelch gene on chromosome ***:All infections were identified as Plasmodium falciparum by RDT and *** fatalities resulted from the *** attack rate was 72.8%(67/92)and the incidence density rate was 14.2 per 100 *** positive rate of rapid diagnostic test(RDT)was 72.2%(65/90)and microscopically-determine parasite rate 42.2%(38/90).Adjusted odds ratio(OR)of multivariate logistic regression analysis for agedcontrol,the detection of malaria attacks,parasites and antigen were reduced to zero between July 1 and December 1,*** cure rate of *** patients at day 42 was 94.3%(95%CI,80.8–99.3%).The PCR did not detect K13-propeller ***:Imported *** caused the ***,seeking inappropriate treatment

关键词： Malaria outbreak Plasmodium falciparum Investigation control Chinese-Myanmar borde

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Chemotherapy-based control of Ascariasis and Hookworm in Highly Endemic Areas of China:Field Observations and a Modeling Analysis

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Biomedical and Environmental Sciences 2012年第3期25卷 272-281页

作者： WANG Jun LI Hua Zhong CHEN Ying Dan LIU Chang Hua TANG Lin Hua National Institute of parasitic Disease Chinese Center for Disease Control and Prevention Shanghai 200025 China Center for Drug Evaluation SFDA Beijing 100038 China office for Disease control and Emergency Response Chinese Center for Disease Control and Prevention Beijing 102206 China Sichuan Center for Disease control and Prevention Chengdu 610041 Sichuan China

Objective Our objective was to systematically evaluate chemotherapy-based control of ascariasis and hookworm infection and make predictions of the effectiveness of repeated mass treatment at different levels of coverage in highly endemic areas of China. Methods Field surveys were carried out to acquire the ascariasis and hookworm prevalence and intensity （mean worm burden） at baseline, one month and one year later. We calculated model parameters based on the survey data, then incorporated them into a quantitative framework to predict the prevalence and intensity one year later. Sensitivity analyses were performed to assess the influence of the chemotherapy measures on prevalence and intensity, and model simulations were performed to evaluate the feasibility of achieving the proposed transmission control criteria under different chemotherapy measures. Results The predicted prevalence and intensity one year from baseline were within the 95% confidence interval of actual values. As treatment frequency or coverage increased, the prevalence and intensity decreased. Model simulations show that many rounds of treatment are needed to maintain the prevalence at a low level in highly endemic areas of China. Conclusion We should select different combinations of treatment frequency, coverage and drug efficacy according to available resources and practical attainable conditions. Mathematical modeling could be used to help optimize the chemotherapeutic scheme aiming at specific parasitic species and areas, and to direct the establishment of soil-transmitted helminthiasis control criteria in China.

关键词： Ascariasis Hookworm Chemotherapy Field survey Mathematical modeling

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Malaria control along China-Myanmar Border during 2007–2013: an integrated impact evaluation

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Infectious diseases of Poverty 2016年第1期5卷 680-690页

作者： Jian-Wei Xu Yong Li Heng-Lin Yang Jun Zhang Zai-Xing Zhang Ya-Ming Yang Hong-Ning Zhou Joshua Havumaki Hua-Xian Li Hui Liu Hua Zhou Xin-Yu Xie Jia-Xiang Dong Yue Zhang Xiao-Ying Sun Bo Li Jia-Yin Li Yang-Hui Tian Pi-Yu Wang Ben-Fu Li Yunnan Institute of parasitic diseases Yunnan Provincial Center of Malaria ResearchYunnan Provincial Collaborative Innovation Center for Public Health and Disease Prevention and ControlYunnan Provincial Key Laboratory of Vector-borne Diseases Control and ResearchPuer 665000China Yunnan Provincial Health and Family Planning Commission Kunming 650200People’s Republic of China Yunnan office of Health Poverty Action Kunming 650041People’s Republic of China World Health organization Regional office for the Western Pacific P.O.Box 29321000 ManilaPhilippines Foundation for Innovative New Diagnostics 1216 CointrinGenevaSwitzerland

Background:Implementing effective interventions remain a lot of difficulties along all border *** emergence of artemisinin resistance of Plasmodium falciparum strains in the Greater Mekong Subregion is a matter of great *** has effectively controlled cross-border transmission of malaria and artemisinin resistance of *** along the China-Myanmar ***:A combined quantitative and qualitative study was used to collect data,and then an integrated impact evaluation was conducted to malaria control along the China-Myanmar border during ***:The parasite prevalence rate(PPR)in the five special regions of Myanmar was decreased from 13.6%in March 2008 to 1.5%in November *** with the baseline(PPR in March 2008),the risk ratio was only 0.11[95%confidence interval(CI),0.09-0.14]in November 2013,which is equal to an 89%reduction in the malaria *** parasite incidence(API)across 19 Chinese border counties was reduced from 19.6 per 10000 person-years in 2006 to 0.9 per 10000 person-years in *** with the baseline(API in 2006),the API rate ratio was only 0.05(95%CI,0.04-0.05)in 2013,which equates to a reduction of the malaria burden by 95.0%.Meanwhile,the health service system was strengthened and health inequity of marginalized populations reduced along the international ***:The effective collaboration between China,Myanmar and the international non-governmental organization promptly carried out the core interventions through simplified *** integrated approaches dramatically decreased malaria burden of Chinese-Myanmar border.

关键词： Border malaria control Artemisinin resistance China-Myanmar border

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National Alveolar Echinococcosis Distribution--China, 2012−2016

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China CDC weekly 2020年第1期2卷 1-7页

作者： Canjun Zheng Chuizhao Xue Shuai Han Zhongjie Li Hu Wang Liying Wang Ying Wang Qian Wang Yu Feng Yanyan Hou Xiao Ma Junying Ma Xiumin Han Gongsang Quzhen Xiaofeng Jiang Weidong Guo Xianglin Wu Yaming Yang Lei Cao Fanka Li Weiqi Chen Xinliu Yan Shicheng Yu Meihua Fu Qing Yu Ning Xiao Jiangping Cao Jun Yan Weiping Wu Xiao-nong Zhou Division of Infectious diseases Chinese Center for Disease Control and PreventionBeijingChina National Institute of parasitic diseases Chinese Center for Disease Control and PreventionChinese Center for Tropical Diseases ResearchWHO Collaborating Centre for Tropical DiseasesNational Center for International Research on Tropical DiseasesMinistry of Science and TechnologyKey Laboratory of Parasite and Vector BiologyMinistry of HealthShanghaiChina Health Commission of Qinghai Province XiningQinghaiChina Sichuan Provincial Center for Disease control and Prevention ChengduSichuanChina Gansu Provincial Center for Disease control and Prevention LanzhouGansuChina Xingjiang Uyghur Autonomous Region Center for Disease control and Prevention UrumqiXinjiangChina Qinhai Institute for Endemic Disease Prevention and control XiningQinghaiChina Qinghai Provincial People’s Hospital XiningQinghaiChina Tibet Center for diseases control and Prevention LhasaTibetChina Inner Mongolia Autonomous Region Center for diseases control and Prevention HohhotInner MongoliaChina Ningxia Center for Disease control and Prevention YinchuanNingxiaChina Yunnan Institute of parasitic diseases PuerYunnanChina Shaanxi Provincial Center for Disease control and Prevention Xi’anShaanxiChina Xinjiang Production and Construction Corps Center for Disease control and Prevention UrumqiXinjiangChina Henan Provincial Center for Disease control and Prevention ZhengzhouHenanChina office of epidemiology Chinese Center for Disease Control and PreventionBeijingChina National Health Commission of the People’s Republic of China BeijingChina.

What is already known about this topic?Both alveolar echinococcosis(AE)and cystic echinococcosis are endemic in China,among which alveolar echinococcosis has a very high mortality *** is added by this report?The survey results showed the prevalence and scope of AE in China and identified high-risk groups including children,monks,herdsmen and illiterate *** the same time,all the cases found in the survey(more than 90%of the patients did not go to the hospital for diagnosis and treatment before survey)were promptly diagnosed and *** are the implications for public health practice?This study provides information for the development of a plan for AE prevention and control and for the implementation of interventions targeted to high-risk populations.

关键词： prevention diagnosis mortality

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How socioeconomic status affected the access to health facilities and malaria diagnosis in children under five years:findings from 19 sub-Saharan African countries

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Infectious diseases of Poverty 2023年第2期12卷 127-127页

作者： Yue Ge Di Liang Jun Cao Roland Gosling Vivian Mushi Jiayan Huang School of Public Health Global Health Institute Fudan University Shanghai China Key Laboratory of National Health Commission on parasitic Disease control and Prevention Key Laboratory of Jiangsu Province on Parasite and Vector Control Technology Jiangsu Institute of Parasitic Diseases Wuxi China Department of Disease control London School of Hygiene and Tropical Medicine London UK Department of Parasitology and Medical Entomology Muhimbili University of Health and Allied Sciences Dar es Salaam Tanzania

Background Prompt and appropriate clinical management of malaria is critical for reducing the continued high burden of malaria among children under five years in sub-Saharan ***,more remains to be known about how a patient’s socioeconomic status(SES)would affect the access to diagnosis of *** In this cross-sectional study using the Demographic and Health Survey and Malaria Indicators Survey,we pooled the data of 38,567 febrile under-five children in 2016–2018 from 19 sub-Saharan *** logistic regression was used to assess the associations between SES and two binary outcomes:the visit to a health facility and a blood test for *** analyses were further conducted by the type of health facilities(public hospitals/public primary healthcare facilities/private hospitals/private primary healthcare facilities)for the latter *** Fifty-eight percent of the febrile children were taken to health facilities,among whom only 55%took blood *** to children from households in the highest wealth quintile,children in the lowest quintile were less likely to be taken to medical facilities[adjusted odds ratio(aOR)=0.775,95%confidence interval(CI):0.675–0.889].Parents with more than secondary education were more likely to seek care(aOR=1.830,95%CI:1.561–2.145)and to have blood tests(aOR=1.729,95%CI:1.436–2.082)for their febrile children than parents without formal *** probabilities of receiving blood tests at public hospitals and public primary healthcare facilities stayed relatively high across parental education levels and wealth quintiles,while these probabilities remained the lowest at private primary healthcare facilities,ranging from 0.100(95%CI:0.074–0.127)to 0.139(95%CI:0.083–0.194)across parental education levels and from 0.104(95%CI:0.078–0.130)to 0.125(95%CI:0.090–0.160)across wealth *** Significant socioeconomic disparities existed both in the access to health facilities

关键词： Malaria diagnosis Children under five years of age Socioeconomic status Healthcare facility Sub-Saharan Africa

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