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Haq IU, Mehmood Z, Khan GA, Kainat B, Ahmed B, Shah J, Sami A, Nazar MS, Xu J, Xiang H. Modeling the effect of climatic conditions and topography on malaria incidence using Poisson regression: a Retrospective study in Bannu, Khyber Pakhtunkhwa, Pakistan. Front Microbiol 2024; 14:1303087. [PMID: 38287956 PMCID: PMC10822983 DOI: 10.3389/fmicb.2023.1303087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/26/2023] [Indexed: 01/31/2024] Open
Abstract
Background Malaria has been identified as a crucial vector-borne disease around the globe. The primary aim of this study was to investigate the incidence of malaria in the district of Bannu and its relationship with climatic conditions such as temperature, rainfall, relative humidity, and topography. Methods Secondary data were obtained from the metrological office and government hospitals across the district for 5 years (2013-2017). A Poisson regression model was applied for the statistical analysis. Results and discussion The number of reported cases of malaria was 175,198. The regression analysis showed that temperature, relative humidity, and rainfall had a significant association (p < 0.05) with malaria incidence. In addition, the topographic variables were significantly associated (p < 0.05) with malaria incidence in the region. The percent variation in the odds ratio of incidence was 4% for every unit increase in temperature and 2% in humidity. In conclusion, this study indicated that the temperature, humidity, rainfall, and topographic variables were significantly associated with the incidence of malaria. Effective malaria control and interventions integrated with climatic factors must be considered to overcome the disease burden.
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Affiliation(s)
- Ijaz Ul Haq
- Department of Public Health & Nutrition, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - Zafar Mehmood
- Department of Maths, Stats & Computer Science, The University of Agriculture Peshawar, Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - Gausal Azam Khan
- Department of Clinical Nutrition, College of Applied Medical Sciences, King Faisal University, Al Ahsa, Saudi Arabia
| | - Bushra Kainat
- Department of Public Health & Nutrition, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - Bilal Ahmed
- School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jahan Shah
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Amtul Sami
- Department of Health Biotechnology, Women University, Swabi, Khyber Pakhtunkhwa, Pakistan
| | - Muhammad Subhan Nazar
- Department of Public Health & Nutrition, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - Jielian Xu
- Department of Clinical Nutrition, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - He Xiang
- Department of Clinical Nutrition, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
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Eyong EEJ, Nkwengang H, Sumo L. Differences in malaria and haematocrit presentation in children living in different settings, North West Region, Cameroon. MALARIAWORLD JOURNAL 2021; 12:2. [PMID: 34532225 PMCID: PMC8415056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Malaria continues to be a major cause of morbidity and mortality in Cameroon. With all efforts being made to eliminate malaria, it is imperative to describe the epidemiology of the disease in different parts of the country in order to inform control policies. This study aimed to present the differences in the prevalence and intensity of malaria and the anaemic status of children living in different areas of the North West region of Cameroon. MATERIALS AND METHODS This study was carried out from April 2016-July 2017. Blood samples were collected from children via finger pricking. Stained thick and thin blood films were examined through microscopy (x100) to detect the presence of parasites and to estimate the geometric mean parasite density (GMPD). Packed cell volume (PCV) values were determined by micro-centrifugation. Data was analysed using SPSS to determine proportions and test for significance levels between these. RESULTS Overall prevalence of malaria was 45.3%. Awing and Obang recorded the highest prevalence while Mankon and Nkwen recorded the lowest (p=0.01). The GMPD of infection was highly heterogeneous between the different localities (p=0.03). Age significantly affected the prevalence of malaria (p=0.02). Sex did not affect the prevalence nor the GMPD of malaria infection (p>0.05). Overall mean PCV value was 32.9±3.9. Localities in urban settings recorded the highest mean PCV values compared to those in rural settings (p=0.68). Sex and age did not affect mean PCV values (p>0.05). CONCLUSION Malaria still remains a major problem in the North West region of Cameroon. Malaria control interventions should therefore be based on evident spatial and temporal heterogeneity of Plasmodium species in a particular area so as not to waste resources that would only be of limited effectiveness and value to the populations at risk.
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Affiliation(s)
- Ebanga Echi J. Eyong
- Department of Biological Sciences, Faculty of Science, University of Bamenda, P.O. Box 39, Bambili, North West Region, Cameroon.,
| | - Hyloson Nkwengang
- Department of Biological Sciences, Faculty of Science, University of Bamenda, P.O. Box 39, Bambili, North West Region, Cameroon
| | - Laurentine Sumo
- Department of Biological Sciences, Faculty of Science, University of Bamenda, P.O. Box 39, Bambili, North West Region, Cameroon
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Bhattarai S, Kolivras KN, Ghimire K, Shao Y. Understanding the relationship between land use and land cover and malaria in Nepal. GEOSPATIAL HEALTH 2020; 15. [PMID: 33461281 DOI: 10.4081/gh.2020.855] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 07/11/2020] [Indexed: 06/12/2023]
Abstract
Malaria is a leading cause of mortality and morbidity globally. Land Use and Land Cover (LULC) change have been found to affect the transmission of malaria in other regions, but no study has examined such relationships in Nepal. Therefore, this study has three aims: first, to analyze the spatial and temporal trend of Malaria Incidence Rate (MIR) between 1999 and 2015, second to assess LULC change between 2000 and 2010, and finally to understand the relationship between LULC and malaria in Nepal. The land cover types examined are forest, water bodies, agriculture, grassland, shrubland, barren areas, built-up areas, and rice paddies. The temporal trend of MIR and the relationship between MIR and LULC were evaluated using Poisson and negative binomial regression. Forest, water bodies, and built-up area increased in Nepal by 0.8%, 8.2%, and 28.4% respectively, while other LULC variables decreased between 2000 and 2010. MIR decreased significantly in 21 districts; however, four districts, namely Pyuthan, Kaski, Rupandehi, and Siraha, had a significantly increasing MIR trend between 1999 and 2015. MIR was positively related to water bodies and rice paddies during 2001, 2002, and 2003 but negatively related to grassland during 2010. However, there was no relationship between LULC and MIR during 2000, 2011, 2012 and 2013. This information will be helpful for public health officials to increase control efforts in those districts and in areas near water bodies and rice paddies to aid in their effort to eliminate malaria from Nepal.
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Affiliation(s)
| | | | - Kabita Ghimire
- Environmental Services Division, Department of Public Works, Prince William County, Virginia.
| | - Yang Shao
- Department of Geography, Virginia Tech, Blacksburg.
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Rajapakshe OBW, Edirisuriya CS, Sivayogan S, Kulatunga PM. Geospatial attributes in psychogeriatric service delivery in the district of Colombo, Sri Lanka. Psychogeriatrics 2019; 19:413-418. [PMID: 30706586 DOI: 10.1111/psyg.12401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 10/01/2018] [Accepted: 12/25/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Mental health is a neglected area within the healthcare systems in developing nations, including Sri Lanka. However, the rapid population aging and the resulting rise in psychological issues among the elderly are becoming major concerns within the country. Therefore, a proper assessment of distribution of mental healthcare facilities within the country is much needed in reducing the unmet need among people with psychological symptoms. In this study, the distribution of mental health services within the district of Colombo, which is the capital of the country, was assessed. METHODS With this view, mapping of mental healthcare services within the district of Colombo was carried out using the Geographic Information System to assess service and human resource availability and physical accessibility to the elderly within the district. RESULTS Certain deficiencies in availability and accessibility of the services were identified which were more significant toward eastern parts of the district. CONCLUSIONS Establishment of new mental healthcare facilities as well as upgrading of already available centres while ensuring availability of professional human resources to these centres is a timely need.
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Affiliation(s)
| | | | | | - Prasadi M Kulatunga
- Department of Psychiatry, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
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Rumisha SF, Shayo EH, Mboera LEG. Spatio-temporal prevalence of malaria and anaemia in relation to agro-ecosystems in Mvomero district, Tanzania. Malar J 2019; 18:228. [PMID: 31288840 PMCID: PMC6617584 DOI: 10.1186/s12936-019-2859-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 07/01/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Agro-ecological systems have been associated with increased malaria intensity. This study determined association between different agro-ecological systems, prevalence of malaria parasitaemia and anaemia in Mvomero district, Tanzania. METHODS The study was carried out in three agro-ecosystems namely, savannah, rice-irrigation, and sugarcane. Malaria and anaemia prevalence were measured in four seasons of a year. Villages were categorized according to environmental characteristics, proportion of water-shaded areas and agro-ecosystems. Mixed-effects logistic regression analysis was used to determine factors associated with malaria infection. RESULTS A total of 7888 individuals were involved with the overall malaria prevalence of 34.4%. Plasmodium falciparum was the dominant (99.52%) malaria species. Malaria prevalence was highest (42.9%) in children of 10-15 years of age, and significantly low during dry and hot season. Of the infected individuals, 78.1% were from rice-irrigation, 18.7% savannah and 3.2% sugarcane ecosystem. Individuals living in villages with high levels of water-shaded areas had highest malaria risk. Over three-quarters (78.9%) of the individuals slept under a mosquito net, with the highest (88.5%) coverage among individuals in sugarcane ecosystem. On average 47.1% of the children were anaemic. Anaemia was more prevalent (60.5%) among individuals in the savannah than in the rice-irrigation (48.2%) or sugarcane communities (23%). Analysis indicated that ecosystems and levels of water-shaded area were highly correlated, and altered levels of malaria infection. Gender, age, mosquito net-use, and season were other significant determinants of P. falciparum infection. Males had higher odds than females (OR = 1.16, 95% CI 1.05, 1.29). The risk for children 6-9 years and older children (10-15 years) was over 50% and 24%, respectively, higher compared to young ones (0-5 years). Use of mosquito net reduced malaria risk by 26%. The risk of infection was higher during dry and cool season (OR = 1.92, 95 %CI 1.66, 2.23) compared to other seasons. Living in villages with high level of water-shaded areas increased the chances of getting malaria up to 15 times than living in drier areas. Similarly, infection odds increased when living in savannah and rice-irrigation ecosystems than in the sugarcane ecosystem. CONCLUSIONS Findings show significant variations in malaria prevalence between communities living in different agro-ecosystems within the same district. Local malaria control strategies should consider these variations and liaise with agricultural experts while designing interventions to maximize effectiveness.
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Affiliation(s)
- Susan F Rumisha
- National Institute for Medical Research, 3 Barack Obama Drive, P.O. Box 9653, Dar es Salaam, Tanzania.
| | - Elizabeth H Shayo
- National Institute for Medical Research, 3 Barack Obama Drive, P.O. Box 9653, Dar es Salaam, Tanzania
| | - Leonard E G Mboera
- National Institute for Medical Research, 3 Barack Obama Drive, P.O. Box 9653, Dar es Salaam, Tanzania
- SACIDS Foundation for One Health, Sokoine University of Agriculture, Chuo Kikuu, P.O. Box 3297, Morogoro, Tanzania
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Jahan F, Khan NH, Wahid S, Ullah Z, Kausar A, Ali N. Malaria epidemiology and comparative reliability of diagnostic tools in Bannu; an endemic malaria focus in south of Khyber Pakhtunkhwa, Pakistan. Pathog Glob Health 2019; 113:75-85. [PMID: 30894081 DOI: 10.1080/20477724.2019.1595904] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
The present study was aimed at elucidation of malaria epidemiology and comparing performance of several diagnostic procedures in Bannu, a highly endemic district of Khyber Pakhtunkhwa, Pakistan. Dried blood spots were collected from patients suspected of malaria visiting a hospital and two private laboratories in district Bannu and processed for species-specific PCR (rRNA). Patients were also screened for malaria through microscopy and RDT. A well-structured questionnaire was used to collect patient information to assess risk factors for malaria. Of 2033 individuals recruited, 21.1% (N = 429) were positive for malaria by at least one method. Overall, positivity detected by PCR was 30.5% (95/311) followed by 17.7% by microscopy (359/2033) and 16.4% by RDT (266/1618). Plasmodium vivax (16.9%, N = 343) was detected as the dominant species followed by Plasmodium falciparum (2.3%, N = 47) and mixed infections (1.2%, N = 39). Microscopy and RDT (Cohen's kappa k = 0.968, p = <0.0001, McNemar test p = 0.069) displayed significant agreement with each other. Satisfactory health, sleeping indoors, presence of health-care facility in vicinity (at an accessible range from home), living in upper middle class and in concrete houses significantly reduced malaria risk; whereas, low literacy level, presence of domestic animals indoors and malaria diagnosis recommended by clinician increased the disease risk. Overall, findings from the study provide reasonable basis for use of RDT as a cost-effective screening tool in field and for clinicians who can proceed with timely treatment of malaria patients. Appropriate management of identified risk factors could contribute to reduction of malaria prevalence in Bannu and its peripheries.
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Affiliation(s)
- Fatima Jahan
- a Department of Zoology , University of Peshawar , Peshawar , Pakistan
| | - Nazma Habib Khan
- a Department of Zoology , University of Peshawar , Peshawar , Pakistan
| | - Sobia Wahid
- a Department of Zoology , University of Peshawar , Peshawar , Pakistan
| | - Zaki Ullah
- b Department of Pharmacy , University of Peshawar , Peshawar , Pakistan
| | - Aisha Kausar
- a Department of Zoology , University of Peshawar , Peshawar , Pakistan
| | - Naheed Ali
- a Department of Zoology , University of Peshawar , Peshawar , Pakistan
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Qayum A, Arya R, Kumar P, Lynn AM. Socio-economic, epidemiological and geographic features based on GIS-integrated mapping to identify malarial hotspots. Malar J 2015; 14:192. [PMID: 25947349 PMCID: PMC4435919 DOI: 10.1186/s12936-015-0685-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2015] [Indexed: 11/26/2022] Open
Abstract
Background Malaria is a major health problem in the tropical and subtropical world. In India, 95% of the population resides in malaria endemic regions and it is major public health problem in most parts of the country. The present work has developed malaria maps by integrating socio-economic, epidemiology and geographical dimensions of three eastern districts of Uttar Pradesh, India. The area has been studied in each dimension separately, and later integrated to find a list of vulnerable pockets/villages, called as malarial hotspots. Methods The study has been done at village level. Seasonal variation of malaria, comparison of epidemiology indices and progress of the medical facility were studied. Ten independent geographical information system (GIS) maps of socio-economic aspects (population, child population, literacy, and work force participation), epidemiology (annual parasitic index (API) and slides collected and examined) and geographical features (settlement, forest cover, water bodies, rainfall, relative humidity, and temperature) were drawn and studied. These maps were overlaid based on computed weight matrix to find malarial hotspot. Results It was found that the studied dimensions were inter-weaving factors for malaria epidemic and closely affected malaria situations as evidenced from the obtained correlation matrix. The regions with water logging, high rainfall and proximity to forest, along with poor socio-economic conditions, are primarily hotspot regions. The work is presented through a series of GIS maps, tables, figures and graphs. A total of 2,054 out of 8,973 villages studied were found to be malarial hotspots and consequently suggestions were made to the concerned government malaria offices. Conclusion With developing technology, information tools such as GIS, have captured almost every field of scientific research especially of vector-borne diseases, such as malaria. Malarial mapping enables easy update of information and effortless accessibility of geo-referenced data to policy makers to produce cost-effective measures for malaria control in endemic regions. Electronic supplementary material The online version of this article (doi:10.1186/s12936-015-0685-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Abdul Qayum
- Centre for Biology & Bioinformatics, School of Computational & Integrative Sciences, Jawaharlal Nehru University, New Delhi, India. .,Indira Gandhi National Forest Academy, Dehradun, India.
| | - Rakesh Arya
- Centre for the Study of Regional Development, Jawaharlal Nehru University, New Delhi, India.
| | | | - Andrew M Lynn
- Centre for Biology & Bioinformatics, School of Computational & Integrative Sciences, Jawaharlal Nehru University, New Delhi, India.
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Jaleta KT, Hill SR, Seyoum E, Balkew M, Gebre-Michael T, Ignell R, Tekie H. Agro-ecosystems impact malaria prevalence: large-scale irrigation drives vector population in western Ethiopia. Malar J 2013; 12:350. [PMID: 24083353 PMCID: PMC3850965 DOI: 10.1186/1475-2875-12-350] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Accepted: 09/20/2013] [Indexed: 11/17/2022] Open
Abstract
Background Development strategies in Ethiopia have largely focused on the expansion of irrigated agriculture in the last decade to reduce poverty and promote economic growth. However, such irrigation schemes can worsen the socio-economic state by aggravating the problem of mosquito-borne diseases. In this study, the effect of agro-ecosystem practices on malaria prevalence and the risk of malaria transmission by the primary vector mosquito, Anopheles arabiensis, in Ethiopia were investigated. Methods In three villages in western Ethiopia practising large-scale sugarcane irrigation, traditional smallholder irrigation and non-irrigated farming, cross-sectional parasitological surveys were conducted during the short rains, after the long rains and during the dry season. Entomological surveys were undertaken monthly (February 2010-January 2011) in each village using light traps, pyrethrum spray collections and artificial pit shelters. Results Malaria prevalence and the risk of transmission by An. arabiensis assessed by the average human biting rate, mean sporozoite rate and estimated annual entomological inoculation rate were significantly higher in the irrigated sugarcane agro-ecosystem compared to the traditionally irrigated and non-irrigated agro-ecosystems. The average human biting rate was significantly elevated by two-fold, while the mean sporozoite rate was 2.5-fold higher, and the annual entomological inoculation rate was 4.6 to 5.7-fold higher in the irrigated sugarcane compared to the traditional and non-irrigated agro-ecosystems. Active irrigation clearly affected malaria prevalence by increasing the abundance of host seeking Anopheles mosquitoes year-round and thus increasing the risk of infective bites. The year-round presence of sporozoite-infected vectors due to irrigation practices was found to strengthen the coupling between rainfall and risk of malaria transmission, both on- and off-season. Conclusion This study demonstrates the negative impact of large-scale irrigation expansion on malaria transmission by increasing the abundance of mosquito vectors and indicates the need for effective vector monitoring and control strategies in the implementation of irrigation projects.
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Affiliation(s)
- Kassahun T Jaleta
- Department of Plant Protection Biology, Unit of Chemical Ecology, Swedish University of Agricultural Sciences, Alnarp, Sweden.
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Long-lasting transition toward sustainable elimination of desert malaria under irrigation development. Proc Natl Acad Sci U S A 2013; 110:15157-62. [PMID: 23942131 DOI: 10.1073/pnas.1305728110] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
In arid areas, people living in the proximity of irrigation infrastructure are potentially exposed to a higher risk of malaria due to changes in ecohydrological conditions that lead to increased vector abundance. However, irrigation provides a pathway to economic prosperity that over longer time scales is expected to counteract these negative effects. A better understanding of this transition between increased malaria risk and regional elimination, in particular whether it is slow or abrupt, is relevant to sustainable development and disease management. By relying on space as a surrogate for stages of time, we investigate this transition in a semidesert region of India where a megairrigation project is underway and expected to cover more than 1,900 million hectares and benefit around 1 million farmers. Based on spatio-temporal epidemiological cases of Plasmodium vivax malaria and land-use irrigation from remote sensing sources, we show that this transition is characterized by an enhanced risk in areas adjacent to the trunk of the irrigation network, despite a forceful and costly insecticide-based control. Moreover, this transition between climate-driven epidemics and sustained low risk has already lasted a decade. Given the magnitude of these projects, these results suggest that increased health costs have to be planned for over a long time horizon. They further highlight the need to integrate assessments of both health and environmental impacts to guide adaptive mitigation strategies. Our results should help to define and track these transitions in other arid parts of the world subjected to similar tradeoffs.
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Sanchez-Ribas J, Parra-Henao G, Guimarães AÉ. Impact of dams and irrigation schemes in Anopheline (Diptera: Culicidae) bionomics and malaria epidemiology. Rev Inst Med Trop Sao Paulo 2012; 54:179-91. [DOI: 10.1590/s0036-46652012000400001] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2011] [Accepted: 04/13/2012] [Indexed: 11/21/2022] Open
Abstract
Irrigation schemes and dams have posed a great concern on public health systems of several countries, mainly in the tropics. The focus of the present review is to elucidate the different ways how these human interventions may have an effect on population dynamics of anopheline mosquitoes and hence, how local malaria transmission patterns may be changed. We discuss different studies within the three main tropical and sub-tropical regions (namely Africa, Asia and the Pacific and the Americas). Factors such as pre-human impact malaria epidemiological patterns, control measures, demographic movements, human behaviour and local Anopheles bionomics would determine if the implementation of an irrigation scheme or a dam will have negative effects on human health. Some examples of successful implementation of control measures in such settings are presented. The use of Geographic Information System as a powerful tool to assist on the study and control of malaria in these scenarios is also highlighted.
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Al-Mekhlafi AM, Al-Mekhlafi HM, Mahdy MAK, Azazy AA, Fong MY. Human malaria in the highlands of Yemen. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 2011; 105:187-95. [PMID: 21801497 PMCID: PMC4090792 DOI: 10.1179/136485911x12987676649421] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2010] [Revised: 02/08/2011] [Accepted: 02/10/2011] [Indexed: 12/28/2022]
Abstract
Between June 2008 and March 2009, a cross-sectional study of human malaria was carried out in four governorates of Yemen, two (Taiz and Hodiedah) representing the country's highlands and the others (Dhamar and Raymah) the country's coastal plains/foothills. The main aims were to determine the prevalences of Plasmodium infection among 455 febrile patients presenting for care at participating health facilities and to investigate the potential risk factors for such infection. Malarial infection was detected in 78 (17·1%) of the investigated patients and was more likely to be detected among the febrile patients from the highlands than among those presenting in the coastal plains/foothills (22·6% v.13·9%; χ(2)=10·102; P=0·018). Binary logistic-regression models identified low household income [odds ratio (OR)=13·52; 95% confidence interval (CI)=2·62-69·67; P=0·002], living in a household with access to a water pump (OR=4·18; CI=1·60-10·96; P=0·004) and living in a household near a stream (OR=4·43; CI=1·35-14·56; P=0·014) as significant risk factors for malarial infection in the highlands. Low household income was the only significant risk factor identified for such infection in the coastal plains and foothills (OR = 8·20; CI=1·80-37·45; P=0·007). It is unclear why febrile patients in the highlands of Yemen are much more likely to be found to have malarial infection than their counterparts from the coastal plains and foothills. Although it is possible that malarial transmission is relatively intense in the highlands, it seems more likely that, compared with those who live at lower altitudes, those who live in the highlands are less immune to malaria, and therefore more likely to develop febrile illness following malarial infection. Whatever the cause of the symptomatic malarial infection commonly found in the highlands of Yemen, it is a matter of serious concern that should be addressed in the national strategy to control malaria.
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Malaria vector control: from past to future. Parasitol Res 2011; 108:757-79. [PMID: 21229263 DOI: 10.1007/s00436-010-2232-0] [Citation(s) in RCA: 120] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2010] [Accepted: 10/06/2010] [Indexed: 01/17/2023]
Abstract
Malaria is one of the most common vector-borne diseases widespread in the tropical and subtropical regions. Despite considerable success of malaria control programs in the past, malaria still continues as a major public health problem in several countries. Vector control is an essential part for reducing malaria transmission and became less effective in recent years, due to many technical and administrative reasons, including poor or no adoption of alternative tools. Of the different strategies available for vector control, the most successful are indoor residual spraying and insecticide-treated nets (ITNs), including long-lasting ITNs and materials. Earlier DDT spray has shown spectacular success in decimating disease vectors but resulted in development of insecticide resistance, and to control the resistant mosquitoes, organophosphates, carbamates, and synthetic pyrethroids were introduced in indoor residual spraying with needed success but subsequently resulted in the development of widespread multiple insecticide resistance in vectors. Vector control in many countries still use insecticides in the absence of viable alternatives. Few developments for vector control, using ovitraps, space spray, biological control agents, etc., were encouraging when used in limited scale. Likewise, recent introduction of safer vector control agents, such as insect growth regulators, biocontrol agents, and natural plant products have yet to gain the needed scale of utility for vector control. Bacterial pesticides are promising and are effective in many countries. Environmental management has shown sufficient promise for vector control and disease management but still needs advocacy for inter-sectoral coordination and sometimes are very work-intensive. The more recent genetic manipulation and sterile insect techniques are under development and consideration for use in routine vector control and for these, standardized procedures and methods are available but need thorough understanding of biology, ethical considerations, and sufficiently trained manpower for implementation being technically intensive methods. All the methods mentioned in the review that are being implemented or proposed for implementation needs effective inter-sectoral coordination and community participation. The latest strategy is evolution-proof insecticides that include fungal biopesticides, Wolbachia, and Denso virus that essentially manipulate the life cycle of the mosquitoes were found effective but needs more research. However, for effective vector control, integrated vector management methods, involving use of combination of effective tools, is needed and is also suggested by Global Malaria Control Strategy. This review article raises issues associated with the present-day vector control strategies and state opportunities with a focus on ongoing research and recent advances to enable to sustain the gains achieved so far.
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Zhou SS, Huang F, Wang JJ, Zhang SS, Su YP, Tang LH. Geographical, meteorological and vectorial factors related to malaria re-emergence in Huang-Huai River of central China. Malar J 2010; 9:337. [PMID: 21092326 PMCID: PMC3003275 DOI: 10.1186/1475-2875-9-337] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2010] [Accepted: 11/24/2010] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Malaria still represents a significant public health problem in China, and the cases dramatically increased in the areas along the Huang-Huai River of central China after 2001. Considering spatial aggregation of malaria cases and specific vectors, the geographical, meteorological and vectorial factors were analysed to determine the key factors related to malaria re-emergence in these particular areas. METHODS The geographic information of 357 malaria cases and 603 water bodies in 113 villages were collected to analyse the relationship between the residence of malaria cases and water body. Spearman rank correlation, multiple regression, curve fitting and trend analysis were used to explain the relationship between the meteorological factors and malaria incidence. Entomological investigation was conducted in two sites to get the vectorial capacity and the basic reproductive rate to determine whether the effect of vector lead to malaria re-emergence. RESULTS The distances from household of cases to the nearest water-body was positive-skew distributed, the median was 60.9 m and 74% malaria cases were inhabited in the extent of 60 m near the water body, and the risk rate of people live there attacked by malaria was higher than others(OR = 1.6, 95%CI (1.042, 2.463), P < 0.05). The annual average temperature and rainfall may have close relationship with annual incidence. The average monthly temperature and rainfall were the key factors, and the correlation coefficients are 0.501 and 0.304(P < 0.01), respectively. Moreover, 75.3% changes of monthly malaria incidence contributed to the average monthly temperature (T(mean)), the average temperature of last two months(T(mean₀₁)) and the average rainfall of current month (R(mean)) and the regression equation was Y = -2.085 + 0.839I₁ + 0.998T(mean₀) - 0.86T(mean₀₁) + 0.16R(mean₀). All the collected mosquitoes were Anopheles sinensis. The vectorial capacity and the basic reproductive rate of An. sinensis in two sites were 0.6969, 0.4983 and 2.1604, 1.5447, respectively. CONCLUSION The spatial distribution between malaria cases and water-body, the changing of meteorological factors, and increasing vectorial capacity and basic reproductive rate of An. sinensis leaded to malaria re-emergence in these areas.
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Affiliation(s)
- Shui S Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis; Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, PR China
| | - Fang Huang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis; Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, PR China
| | - Jian J Wang
- Department of Parasitology, Anhui Center for Disease Control and Prevention, Hefei 230061, PR China
| | - Shao S Zhang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis; Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, PR China
| | - Yun P Su
- Department of Parasitology, Henan Center for Disease Control and Prevention, Zhengzhou, 450003, PR China
| | - Lin H Tang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis; Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, PR China
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14
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Abstract
The prospect of malaria eradication has been raised recently by the Bill and Melinda Gates Foundation with support from the international community. There are significant lessons to be learned from the major successes and failures of the eradication campaign of the 1960s, but cessation of transmission in the malaria heartlands of Africa will depend on a vaccine and better drugs and insecticides. Insect control is an essential part of reducing transmission. To date, two operational scale interventions, indoor residual spraying and deployment of long-lasting insecticide-treated nets (LLINs), are effective at reducing transmission. Our ability to monitor and evaluate these interventions needs to be improved so that scarce resources can be sensibly deployed, and new interventions that reduce transmission in a cost-effective and efficient manner need to be developed. New interventions could include using transgenic mosquitoes, larviciding in urban areas, or utilizing cost-effective consumer products. Alongside this innovative development agenda, the potential negative impact of insecticide resistance, particularly on LLINs, for which only pyrethroids are available, needs to be monitored.
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Affiliation(s)
- A Enayati
- School of Public Health and Environmental Health Research Centre, Mazandaran University of Medical Sciences, Sari, Iran.
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15
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Ohba SY, Kashima S, Matsubara H, Higa Y, Piyaseeli UKD, Yamamoto H, Nakasuji F. Mosquito breeding sites and People’s knowledge of mosquitoes and mosquito borne diseases: A comparison of temporary housing and non-damaged village areas in Sri Lanka after the tsunami strike in 2004. Trop Med Health 2010. [DOI: 10.2149/tmh.2009-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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16
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Kibret S, Alemu Y, Boelee E, Tekie H, Alemu D, Petros B. The impact of a small-scale irrigation scheme on malaria transmission in Ziway area, Central Ethiopia. Trop Med Int Health 2009; 15:41-50. [PMID: 19917039 DOI: 10.1111/j.1365-3156.2009.02423.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess the impact of a small-scale irrigation scheme in Ziway area, a semi-arid area in the Central Ethiopian Rift Valley, on malaria transmission. METHOD Parasitological, entomological and socio-economic studies were conducted in a village with and a village without irrigation. Blood smear samples were taken from individuals during the dry and wet seasons of 2005/2006. Socio-economic data were collected from household heads and key agricultural and health informants through interviews and questionnaires. Larval and adult mosquitoes were sampled during the dry and short wet seasons of 2006. Female anopheline mosquitoes were tested by enzyme-linked immunosorbent assay for blood meal sources and sporozoite infections. RESULTS Malaria prevalence was higher in the irrigated village (19%, P < 0.05) than the non-irrigated village (16%). In the irrigated village, malaria prevalence was higher in the dry season than in the wet season while the reverse occurred in the non-irrigated village. Households with access to irrigation had larger farm land sizes and higher incomes, but also higher prevalence of malaria. Larval and adult abundance of the malaria vectors, Anopheles arabiensis and Anopheles pharoensis, was higher in the irrigated than in the non-irrigated village throughout the study period. Furthermore, the abundance of An. pharoensis was significantly higher than that of An. arabiensis during the dry irrigated period of the year. Canal leakage pools, irrigated fields and irrigation canals were the major breeding habitats of the two vector mosquitoes. Plasmodium falciparum sporozoite infection rates of 1.18% and 0.66% were determined for An. arabiensis and An. pharoensis in the irrigated village. Peak biting activities of the vectors occurred before 22:00 h, which is a source of concern that the effectiveness of ITNs may be compromised as the mosquitoes feed on blood before people go to bed. CONCLUSION Irrigation schemes along the Ethiopian Rift Valley may intensify malaria by increasing the level of prevalence during the dry season. To reduce the intensity of malaria transmission in the small-scale irrigation schemes currently in operation in Ethiopia, year-round source reduction by using proper irrigation water management, coupled with health education, needs to be incorporated into the existing malaria control strategies.
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Affiliation(s)
- Solomon Kibret
- Department of Biology, Addis Ababa University, Addis Ababa, Ethiopia.
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17
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Clements ACA, Barnett AG, Cheng ZW, Snow RW, Zhou HN. Space-time variation of malaria incidence in Yunnan province, China. Malar J 2009; 8:180. [PMID: 19646240 PMCID: PMC2724544 DOI: 10.1186/1475-2875-8-180] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2008] [Accepted: 07/31/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Understanding spatio-temporal variation in malaria incidence provides a basis for effective disease control planning and monitoring. METHODS Monthly surveillance data between 1991 and 2006 for Plasmodium vivax and Plasmodium falciparum malaria across 128 counties were assembled for Yunnan, a province of China with one of the highest burdens of malaria. County-level Bayesian Poisson regression models of incidence were constructed, with effects for rainfall, maximum temperature and temporal trend. The model also allowed for spatial variation in county-level incidence and temporal trend, and dependence between incidence in June-September and the preceding January-February. RESULTS Models revealed strong associations between malaria incidence and both rainfall and maximum temperature. There was a significant association between incidence in June-September and the preceding January-February. Raw standardised morbidity ratios showed a high incidence in some counties bordering Myanmar, Laos and Vietnam, and counties in the Red River valley. Clusters of counties in south-western and northern Yunnan were identified that had high incidence not explained by climate. The overall trend in incidence decreased, but there was significant variation between counties. CONCLUSION Dependence between incidence in summer and the preceding January-February suggests a role of intrinsic host-pathogen dynamics. Incidence during the summer peak might be predictable based on incidence in January-February, facilitating malaria control planning, scaled months in advance to the magnitude of the summer malaria burden. Heterogeneities in county-level temporal trends suggest that reductions in the burden of malaria have been unevenly distributed throughout the province.
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Affiliation(s)
- Archie CA Clements
- University of Queensland, School of Population Health, Herston, Queensland, Australia
- Australian Centre for International and Tropical Health, Queensland Institute of Medical Research, Herston, Queensland, Australia
| | - Adrian G Barnett
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Zhang Wei Cheng
- Yunnan Institute of Parasitic Diseases, Pu'er, Yunnan, PR China
| | - Robert W Snow
- Malaria Public Health and Epidemiology Group, Centre for Geographic Medicine, KEMRI – University of Oxford – Wellcome Trust Collaborative Programme, Nairobi, Kenya
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, CCVTM, Oxford, UK
| | - Hom Ning Zhou
- Yunnan Institute of Parasitic Diseases, Pu'er, Yunnan, PR China
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Chirowodza A, van Rooyen H, Joseph P, Sikotoyi S, Richter L, Coates T. USING PARTICIPATORY METHODS AND GEOGRAPHIC INFORMATION SYSTEMS (GIS) TO PREPARE FOR AN HIV COMMUNITY-BASED TRIAL IN VULINDLELA, SOUTH AFRICA (Project Accept-HPTN 043). JOURNAL OF COMMUNITY PSYCHOLOGY 2009; 37:41-57. [PMID: 19774224 PMCID: PMC2747527 DOI: 10.1002/jcop.20294] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Recent attempts to integrate geographic information systems (GIS) and participatory techniques, have given rise to terminologies such as participatory GIS and community-integrated GIS. Although GIS was initially developed for physical geographic application, it can be used for the management and analysis of health and health care data. Geographic information systems, combined with participatory methodology, have facilitated the analysis of access to health facilities and disease risk in different populations. Little has been published about the usefulness of combining participatory methodologies and GIS technology in an effort to understand and inform community-based intervention studies, especially in the context of HIV. This article attempts to address this perceived gap in the literature. The authors describe the application of participatory research methods with GIS in the formative phase of a multisite community-based social mobilization trial, using voluntary counseling and testing and post-test support as the intervention.
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Affiliation(s)
- Admire Chirowodza
- Human Sciences Research Council (HSRC) and University of KwaZulu-Natal
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19
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Power R, Langhaug L, Cowan F. "But there are no snakes in the wood": risk mapping as an outcome measure in evaluating complex interventions. Sex Transm Infect 2007; 83:232-6. [PMID: 17344248 PMCID: PMC2659103 DOI: 10.1136/sti.2006.022434] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To complement biological and social behavioural markers in evaluating the complex intervention of sexual and reproductive health among adolescents in rural Zimbabwe, community-derived markers of effectiveness were sought. Through a participatory workshop with adolescent boys and girls, an innovative "risk map research workshop" was developed to be conducted throughout the study sites. METHODS 78 gender-specific standardised workshops were conducted among secondary school students. Participants drew risk maps of their community. Focus group discussions explored each risk area identified on the map. Grounded Theory was used to create "categories" and "subcategories." Workshops continued to be held until "saturation", whereby no new categories emerged. "Axial coding" identified the inter-relationship between categories and subcategories according to their relevance to sexual and reproductive health risk. RESULTS Six "risk area" Grounded Theory categories emerged from the data: bush/rural terrain, commercial centres, homes, school environs, religious and spiritual venues, and roadsides. 17 subcategories emerged, grouped under each of the risk area categories, such as riverbeds, growth points, homesteads, classrooms, all-night prayer meetings and truck stops. Risks and the consequences of risks included sexually transmitted infections (including HIV), violence, sexual abuse, expulsion from school and illegal abortion. CONCLUSIONS Risk maps provide unique data that can be used to measure more subtle changes that occur as a result of social behavioural interventions aimed at addressing reproductive and sexual health. Another round of risk map research workshops will be held towards the end of the study to explore changes in milieu, behaviour and experiences, and will complement and triangulate the biological and other social behavioural outcome measures.
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Affiliation(s)
- Robert Power
- Burnet Institute for Medical Research and Public Health, Melbourne, Victoria 3001, Australia.
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20
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Kelly-Hope LA, Yapabandara AMGM, Wickramasinghe MB, Perera MDB, Karunaratne SHPP, Fernando WP, Abeyasinghe RR, Siyambalagoda RRMLR, Herath PRJ, Galappaththy GNL, Hemingway J. Spatiotemporal distribution of insecticide resistance in Anopheles culicifacies and Anopheles subpictus in Sri Lanka. Trans R Soc Trop Med Hyg 2006; 99:751-61. [PMID: 16099009 DOI: 10.1016/j.trstmh.2005.05.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2004] [Revised: 04/26/2005] [Accepted: 05/06/2005] [Indexed: 11/17/2022] Open
Abstract
The malaria situation in Sri Lanka worsened during the 1990s with the emergence and spread of resistance to the drugs and insecticides used for control. Chloroquine resistance has increased rapidly over this period, but adverse changes in malaria transmission are more closely associated with insecticide use rather than drug resistance. Insecticide susceptibility tests were routinely carried out in key anopheline vectors across the country for more than a decade. These sentinel data were combined with data collected by other research programmes and used to map the spatial and temporal trends of insecticide resistance in the main vectors, Anopheles culicifacies and A. subpictus, and to examine the relationship between insecticide resistance, changes in national spraying regimens and malaria prevalence. Both species had widespread resistance to malathion, the insecticide of choice in the early 1990s. Both species were initially susceptible to the organophosphate and pyrethroid insecticides used operationally from 1993, but some resistance has now been selected. The levels of malathion and fenitrothion resistance in A. subpictus were higher in some ecological regions than others, which may be related to the distribution of sibling species, agricultural pesticide exposure and/or environmental factors. The study highlights that the emergence and spread of insecticide resistance is a constant threat and that active surveillance systems are vital in identifying key vectors and evidence of resistance.
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Affiliation(s)
- L A Kelly-Hope
- Vector Research Group, Liverpool School of Tropical Medicine, Pembroke Place, UK
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21
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Erhart A, Thang ND, Van Ky P, Tinh TT, Van Overmeir C, Speybroeck N, Obsomer V, Hung LX, Thuan LK, Coosemans M, D'alessandro U. Epidemiology of forest malaria in central Vietnam: a large scale cross-sectional survey. Malar J 2005; 4:58. [PMID: 16336671 PMCID: PMC1325238 DOI: 10.1186/1475-2875-4-58] [Citation(s) in RCA: 120] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2005] [Accepted: 12/08/2005] [Indexed: 11/10/2022] Open
Abstract
In Vietnam, a large proportion of all malaria cases and deaths occurs in the central mountainous and forested part of the country. Indeed, forest malaria, despite intensive control activities, is still a major problem which raises several questions about its dynamics. A large-scale malaria morbidity survey to measure malaria endemicity and identify important risk factors was carried out in 43 villages situated in a forested area of Ninh Thuan province, south central Vietnam. Four thousand three hundred and six randomly selected individuals, aged 10–60 years, participated in the survey. Rag Lays (86%), traditionally living in the forest and practising "slash and burn" cultivation represented the most common ethnic group. The overall parasite rate was 13.3% (range [0–42.3] while Plasmodium falciparum seroprevalence was 25.5% (range [2.1–75.6]). Mapping of these two variables showed a patchy distribution, suggesting that risk factors other than remoteness and forest proximity modulated the human-vector interactions. This was confirmed by the results of the multivariate-adjusted analysis, showing that forest work was a significant risk factor for malaria infection, further increased by staying in the forest overnight (OR= 2.86; 95%CI [1.62; 5.07]). Rag Lays had a higher risk of malaria infection, which inversely related to education level and socio-economic status. Women were less at risk than men (OR = 0.71; 95%CI [0.59; 0.86]), a possible consequence of different behaviour. This study confirms that malaria endemicity is still relatively high in this area and that the dynamics of transmission is constantly modulated by the behaviour of both humans and vectors. A well-targeted intervention reducing the "vector/forest worker" interaction, based on long-lasting insecticidal material, could be appropriate in this environment.
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Affiliation(s)
- Annette Erhart
- Prince Leopold Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium
| | - Ngo Duc Thang
- National Institute for Malariology, Parasitology and Entomology, Luong The Vinh street, BC 10200 Tu Liem district, Hanoi, Vietnam
| | - Phan Van Ky
- Provincial Centre for Malariology, Parasitology and Entomology, 156 Ngo Gia Tu Street, Phan Rang city, Ninh Thuan province, Vietnam
| | - Ta Thi Tinh
- National Institute for Malariology, Parasitology and Entomology, Luong The Vinh street, BC 10200 Tu Liem district, Hanoi, Vietnam
| | - Chantal Van Overmeir
- Prince Leopold Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium
| | - Niko Speybroeck
- Prince Leopold Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium
| | - Valerie Obsomer
- Prince Leopold Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium
| | - Le Xuan Hung
- National Institute for Malariology, Parasitology and Entomology, Luong The Vinh street, BC 10200 Tu Liem district, Hanoi, Vietnam
| | - Le Khanh Thuan
- National Institute for Malariology, Parasitology and Entomology, Luong The Vinh street, BC 10200 Tu Liem district, Hanoi, Vietnam
| | - Marc Coosemans
- Prince Leopold Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium
| | - Umberto D'alessandro
- Prince Leopold Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium
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22
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Abstract
OBJECTIVE To review the evidence on the link between malaria and poverty. METHODS Review of the published and grey literature to identify (i) the data available on the socio-economic distribution of malaria incidence and vulnerability, and (ii) the uptake of malaria control interventions. RESULTS We found mixed evidence on malaria incidence, with a number of studies identifying no relationship between socio-economic status and incidence, although a larger number of studies do find a link. There is strong evidence that uptake of preventive and treatment interventions is closely related to proxies for socio-economic status. More generally, the quality of the literature examining this issue is highly variable, with many different measures of socio-economic status and often inadequate descriptions of methods of data collection and analysis in relation to socio-economic status. CONCLUSIONS Important socio-economic differentials exist in access to malaria interventions, increasing the vulnerability of the poorest. More information is needed about how other methods of delivering malaria treatment and prevention can redress these inequalities.
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Affiliation(s)
- Eve Worrall
- Liverpool Associates in Tropical Health, Liverpool, UK.
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