Spatial Heterogeneity of Malaria in Ghana: a Cross-sectional Study on the Association Between Urbanicity and the Acquisition of Immunity

Overview

Journal Malar J

Publisher Biomed Central

Specialty Tropical Medicine

Date 2016 Feb 13

PMID 26867774

Citations 8

Authors

Clemens Frank

Ralf Krumkamp

Nimako Sarpong

Peter Sothmann

Julius N Fobil

Geoffrey Foli

Anna Jaeger

Lutz Ehlkes

Ellis Owusu-Dabo

Yaw Adu-Sarkodie

Florian Marks

Ralf R Schumann

Jurgen May

Benno Kreuels

Affiliations

Soon will be listed here.

Abstract

Background: Malaria incidence has declined considerably over the last decade. This is partly due to a scale-up of control measures but is also attributed to increasing urbanization. This study aimed to analyse the association between malaria and urbanization and the effect of urbanicity on the acquisition of semi-immunity.

Methods: In 2012, children with fever presenting to St Michael's Hospital Pramso/Ghana were recruited. The malaria-positive-fraction (MPF) of fever cases was calculated on community-level to approximate the malaria risk. The mean age of malaria cases was calculated for each community to estimate the acquisition of semi-immunity. The level of urbanicity for the communities was calculated and associations between MPF, urbanicity and immunity were modelled using linear regression.

Results: Twenty-six villages were included into the study with a mean MPF of 35 %. A linear decrease of 5 % (95 % CI: 4-6 %) in MPF with every ten-point increase in urbanicity was identified. The mean age of malaria patients increased by 2.9 months (95 % CI: 1.0-4.8) with every ten-point increase in urbanicity.

Discussion: The results confirm an association between an increase in urbanicity and declining malaria risk and demonstrate that the acquisition of semi-immunity is heterogeneous on a micro-epidemiological scale and is associated with urbanicity.

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