TY - JOUR
T1 - House structure is associated with malaria among febrile patients in a high-transmission region of zambia
AU - Sikalima, Jay
AU - Schue, Jessica L.
AU - Hill, Sarah E.
AU - Mulenga, Modest
AU - Handema, Ray
AU - Daka, Victor
AU - Chileshe, Justin
AU - Kasongo, Webster
AU - Chaponda, Mike
AU - Kabuya, Jean Bertin Bukasa
AU - Moss, William J.
AU - Ippolito, Matthew M.
N1 - Funding Information:
Financial support: The parent study was funded by Meridian Bioscience (USA) and Sep Sci (Zambia). J. S., M. M., W. J. M., and M. M. I. were supported by the National Institutes of Health (U19AI089680). J. L. S. and M. M. I. were supported by the Johns Hopkins Malaria Research Institute and Bloomberg Philanthropies. M. M. I. was supported by the National Institutes of Health (K23AI139343), the Sher-rilyn and Ken Fisher Center for Environmental Infectious Disease at Johns Hopkins University, and the Burroughs Wellcome Fund-American Society of Tropical Medicine and Hygiene Postdoctoral Fellowship in Tropical Infectious Diseases. The contents of this article are solely the responsibility of the authors and do not necessarily represent the official view of the Fisher Center or Johns Hopkins University School of Medicine.
Publisher Copyright:
© 2021 by The American Society of Tropical Medicine and Hygiene.
PY - 2021/6
Y1 - 2021/6
N2 - Since the late nineteenth century, the importance of house structure as a determinant of malaria risk has been recognized. Few studies to date have examined the association of housing and malaria in clinical populations. We conducted a cross-sectional study of febrile patients (n = 282) at two rural health clinics in a high malaria-transmission area of northern Zambia. Participants underwent testing for Plasmodium falciparum infection by PCR. Demographic and other risk factors including house structure, indoor residual spraying (IRS), bed net use, education level, and household income were collected. Data were fitted to logistic regression models for relational and mediation analyses. Residing in a house with a thatch roof was associated with higher odds of malaria than residing in a house with corrugated metal (odds ratio: 2.6; 95% CI: 1.0-6.3, P = 0.04). Lower income and educational attainment were also associated with greater odds of malaria. Living under a thatch roof accounted for 24% (95% CI: 14-82) of the effect of household income on malaria risk, and income accounted for11%(95% CI: 8-19) of the effect of education. Neither IRS nor bed net use was associated with malaria risk despite large, local investments in these vector control interventions. The findings testify to malaria as a disease of rural poverty and contribute further evidence to the utility of housing improvements in vector control programs.
AB - Since the late nineteenth century, the importance of house structure as a determinant of malaria risk has been recognized. Few studies to date have examined the association of housing and malaria in clinical populations. We conducted a cross-sectional study of febrile patients (n = 282) at two rural health clinics in a high malaria-transmission area of northern Zambia. Participants underwent testing for Plasmodium falciparum infection by PCR. Demographic and other risk factors including house structure, indoor residual spraying (IRS), bed net use, education level, and household income were collected. Data were fitted to logistic regression models for relational and mediation analyses. Residing in a house with a thatch roof was associated with higher odds of malaria than residing in a house with corrugated metal (odds ratio: 2.6; 95% CI: 1.0-6.3, P = 0.04). Lower income and educational attainment were also associated with greater odds of malaria. Living under a thatch roof accounted for 24% (95% CI: 14-82) of the effect of household income on malaria risk, and income accounted for11%(95% CI: 8-19) of the effect of education. Neither IRS nor bed net use was associated with malaria risk despite large, local investments in these vector control interventions. The findings testify to malaria as a disease of rural poverty and contribute further evidence to the utility of housing improvements in vector control programs.
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U2 - 10.4269/ajtmh.20-1378
DO - 10.4269/ajtmh.20-1378
M3 - Article
C2 - 33844650
AN - SCOPUS:85107545094
SN - 0002-9637
VL - 104
SP - 2131
EP - 2138
JO - American Journal of Tropical Medicine and Hygiene
JF - American Journal of Tropical Medicine and Hygiene
IS - 6
ER -