The role of age, ethnicity and environmental factors in modulating malaria risk in Rajasthali, Bangladesh

Malaria Journal

Research

Korine N Kolivras¹  Gregory E Glass²  Wolf-Peter Schmidt³  Dipak Mitra⁴  Rashidul Haque⁴  Ubydul Haque⁵  Ricardo J Soares Magalhães⁶ 

[1] Department of Geography, Virginia Tech, 24061, Blacksburg, VA, USA;Department of Molecular Microbiology and Immunology, John Hopkins Bloomberg School of Public Health, 21205, Baltimore, MD, USA;Environmental Health Group, Disease Control & Vector Biology Unit, London School of Hygiene and Tropical Medicine, London, UK;International Center for Diarrhoeal Disease Research Bangladesh, 68 Shaheed Tajuddin Ahmed Sharani, 1212, Mohakhali, Dhaka, Bangladesh;International Center for Diarrhoeal Disease Research Bangladesh, 68 Shaheed Tajuddin Ahmed Sharani, 1212, Mohakhali, Dhaka, Bangladesh;Department of Mathematical Sciences and Technology, Norwegian University of Life Sciences, Ås, Norway;School of Population Health, University of Queensland, Herston, Queensland, Australia;

关键词: Malaria;    Malaria Control;    Malaria Prevalence;    Malaria Risk;    Household Density;   

DOI  :  10.1186/1475-2875-10-367

 received in 2011-07-21, accepted in 2011-12-15,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundMalaria is endemic in the Rajasthali region of the Chittagong Hill Tracts in Bangladesh and the Rajasthali region is the most endemic area of Bangladesh. Quantifying the role of environmental and socio-economic factors in the local spatial patterns of malaria endemicity can contribute to successful malaria control and elimination. This study aimed to investigate the role of environmental factors on malaria risk in Rajasthali and to quantify the geographical clustering in malaria risk unaccounted by these factors.MethodA total of 4,200 (78.9%; N = 5,322) households were targeted in Rajasthali in July, 2009, and 1,400 individuals were screened using a rapid diagnostic test (Falci-vax). These data were linked to environmental and socio-economic data in a geographical information system. To describe the association between environmental factors and malaria risk, a generalized linear mixed model approach was utilized. The study investigated the role of environmental factors on malaria risk by calculating their population-attributable fractions (PAF), and used residual semivariograms to quantify the geographical clustering in malaria risk unaccounted by these factors.ResultsOverall malaria prevalence was 11.7%. Out of 5,322 households, 44.12% households were living in areas with malaria prevalence of ≥ 10%. The results from statistical analysis showed that age, ethnicity, proximity to forest, household density, and elevation were significantly and positively correlated with the malaria risk and PAF estimation. The highest PAF of malaria prevalence was 47.7% for third tertile (n = 467) of forest cover, 17.6% for second tertile (n = 467) of forest cover and 19.9% for household density >1,000.ConclusionTargeting of malaria health interventions at small spatial scales in Bangladesh should consider the social and socio-economic risk factors identified as well as alternative methods for improving equity of access to interventions across whole communities.

【 授权许可】

CC BY   
© Haque et al; licensee BioMed Central Ltd. 2011