Household living conditions and individual behaviours associated with malaria risk: a community-based survey in the Limpopo River Valley, 2020, South Africa

Malaria Journal

Research

Jean Gaudart¹  Helene Trehard²  Marc-Karim Bendiane²  Sean M. Patrick³  Bernice N. Harris³  Megan A. Riddin³  Christiaan de Jager³  Taneshka Kruger³  Riana Bornman³ 

[1]Aix Marseille University, INSERM, IRD, APHM, ISSPAM, SESSTIM, UMR1252, Hospital La Timone, BioSTIC, Biostatistics & ICT, 13005, Marseille, France

[2]Economics & Social Sciences Applied to Health & Medical Information Processing, Aix Marseille University, INSERM, IRD, ISSPAM, SESSTIM, 13005, Marseille, France

[3]UP Institute for Sustainable Malaria Control & MRC Collaborating Centre for Malaria Research, School of Health Systems and Public Health, University of Pretoria, Private Bag X20, Hatfield, 0028, Pretoria, South Africa

关键词: Malaria;    Limpopo;    South Africa;    Border;    Community-based survey;    Health Behaviors;    Housing conditions;   

DOI  :  10.1186/s12936-023-04585-4

 received in 2023-01-23, accepted in 2023-05-09,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundOver the past decade, implementation of multiple malaria control strategies in most countries has largely contributed to advance the global malaria elimination agenda. Nevertheless, in some regions, seasonal epidemics may adversely affect the health of local populations. In South Africa, Plasmodium falciparum malaria is still present, with the Vhembe District experiencing an incidence rate of 3.79 cases/1000 person-years in 2018, particularly in the Limpopo River Valley, bordering Zimbabwe. To elucidate the complexity of the mechanisms involved in local regular malaria outbreaks, a community-based survey was implemented in 2020 that focused on the relationship between housing conditions and malaria risky behaviours.MethodsThe community-based cross-sectional survey was conducted among the population of three study sites in the Vhembe District, which were selected based on malaria incidence rate, social and health characteristics of inhabitants. The household survey used a random sampling strategy, where data were collected through face-to-face questionnaires and field notes; to described the housing conditions (housing questionnaire), and focus on individual behaviours of household members. Statistical analyses were performed combining hierarchical classifications and logistic regressions.ResultsIn this study, 398 households were described, covering a population of 1681 inhabitants of all ages, and 439 adults who participated in community-based survey. The analysis of situations at risk of malaria showed that the influence of contextual factors, particularly those defined by the type of habitat, was significant. Housing conditions and poor living environments were factors of malaria exposure and history, regardless of site of investigation, individual preventive behaviours and personal characteristics of inhabitants. Multivariate models showed that, considering all personal characteristics or behaviours of inhabitants, housing conditions such as overcrowding pressures were significantly associated with individual malaria risk.ConclusionsThe results showed the overwhelming weight of social and contextual factors on risk situations. Considering the Fundamental Causes Theory, malaria control policies based on health behaviour prevention, should reinforce access to care or promoting health education actions. Overarching economic development interventions in targeted geographical areas and populations have to be implemented, so that malaria control and elimination strategies can be efficiently and effectively managed.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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