TY - JOUR
T1 - Environmental, socio-demographic and behavioural determinants of malaria risk in the western Kenyan highlands
T2 - A case-control study
AU - Ernst, Kacey C.
AU - Lindblade, Kim A.
AU - Koech, David
AU - Sumba, Peter O.
AU - Kuwuor, Dickens O.
AU - John, Chandy C.
AU - Wilson, Mark L.
PY - 2009/10
Y1 - 2009/10
N2 - Objective To identify risk factors for uncomplicated malaria in highland areas of East Africa at higher risk of malaria epidemics, in order to design appropriate interventions. Methods Prospective, population-based, case-control study in the Nandi Hills, a highland area of western Kenya, to identify environmental, sociodemographic and behavioural factors associated with clinical malaria. Data were collected using field observation, a structured questionnaire, and a global positioning system device. Results We interviewed 488 cases of slide-confirmed malaria and 980 age-matched controls. Multivariate analyses associated higher malaria risk with living <250 m of a forest [OR = 3.3 (95% CI 1.5, 7.1)], <250 m of a swamp [2.8 (1.3, 5.9)], <200 m of maize fields [2.0 (1.2, 3.4)], in the absence of trees <200 m [1.6 (1.2, 2.2)], on flat land [1.6 (1.2, 2.2)], in houses without ceilings [1.5 (1.1, 2.2)], in houses with a separate kitchen building [1.8 (1.4, 2.3)] and in households where the female household head had no education [1.9 (1.1, 3.1)]. Travelling out of the study site [2.2 (1.2, 4.1)] was also associated with increased risk. Conclusions In this East African highland area, risk of developing uncomplicated malaria was multifactorial with a risk factor profile similar to that in endemic regions. Households within close proximity to forest and swamp borders are at higher risk of malaria and should be included in indoor residual spraying campaigns.
AB - Objective To identify risk factors for uncomplicated malaria in highland areas of East Africa at higher risk of malaria epidemics, in order to design appropriate interventions. Methods Prospective, population-based, case-control study in the Nandi Hills, a highland area of western Kenya, to identify environmental, sociodemographic and behavioural factors associated with clinical malaria. Data were collected using field observation, a structured questionnaire, and a global positioning system device. Results We interviewed 488 cases of slide-confirmed malaria and 980 age-matched controls. Multivariate analyses associated higher malaria risk with living <250 m of a forest [OR = 3.3 (95% CI 1.5, 7.1)], <250 m of a swamp [2.8 (1.3, 5.9)], <200 m of maize fields [2.0 (1.2, 3.4)], in the absence of trees <200 m [1.6 (1.2, 2.2)], on flat land [1.6 (1.2, 2.2)], in houses without ceilings [1.5 (1.1, 2.2)], in houses with a separate kitchen building [1.8 (1.4, 2.3)] and in households where the female household head had no education [1.9 (1.1, 3.1)]. Travelling out of the study site [2.2 (1.2, 4.1)] was also associated with increased risk. Conclusions In this East African highland area, risk of developing uncomplicated malaria was multifactorial with a risk factor profile similar to that in endemic regions. Households within close proximity to forest and swamp borders are at higher risk of malaria and should be included in indoor residual spraying campaigns.
KW - Case-control
KW - Environmental
KW - Highland malaria
KW - Household-level
KW - Plasmodium falciparum
KW - Risk factors
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U2 - 10.1111/j.1365-3156.2009.02370.x
DO - 10.1111/j.1365-3156.2009.02370.x
M3 - Article
C2 - 19772547
AN - SCOPUS:70349241866
SN - 1360-2276
VL - 14
SP - 1258
EP - 1265
JO - Tropical Medicine and International Health
JF - Tropical Medicine and International Health
IS - 10
ER -