Socio-demographic Factors, Housing Characteristics, and Clinical Symptoms Associated with Falciparum Malaria in Two Rapidly Urbanizing Areas in the Ashanti Region of Ghana

Overview

Journal Malar J

Publisher Biomed Central

Specialty Tropical Medicine

Date 2024 Nov 22

PMID 39574064

Authors

Stephen Opoku Afriyie

Kwasi Baako Antwi

Abdul-Hakim Mutala

Dawood Ackom Abbas

Kofi Agyapong Addo

Austine Tweneboah

Thomas Kwame Addison

Eric Osei

Cristian Koepfli

Kingsley Badu

Affiliations

Soon will be listed here.

Abstract

Background: Malaria has been described as a disease of poverty, affecting the poorest populations typically living in rural areas. As hitherto rural areas transition into semi-urban environments, this study investigated the prevalence of falciparum malaria and associated risk factors in two rapidly urbanizing districts in the Ashanti Region of Ghana.

Methods: A cross-sectional, hospital-based study was conducted at Agona and Mankranso Government Hospitals located within the Sekyere South and Ahafo Ano Southwest districts respectively, in the Ashanti Region of Ghana. Five µL of venous blood was obtained from suspected malaria patients and tested for malaria using rapid diagnostic test (RDT). Data on socio-demographic factors, clinical symptoms, and housing characteristics were collected using a structured questionnaire. Univariate and multivariate logistic regression analysis were performed to identify risk factors associated with malaria.

Results: A total of 1739 participants were enrolled in the study between January and June 2021 with median age of 22 years (IQR = 6-36). Overall malaria prevalence was 24.8%. Compared to > 30-year-olds, children between 0 and 5 years (aOR = 3.36) and those aged between 6 and 14 (aOR = 6.71) were three and six times more likely to test positive for malaria, respectively. Similarly, farming (aOR = 1.74), compared to other occupations, living close to stagnant water (aOR = 1.34), experiencing chills (aOR = 1.5), and vomiting (aOR = 1.93) were associated with increased odds of malaria infection. Having roofing ceiling (aOR = 0.66) and screened doors (aOR = 0.75) were associated with decreased risk of malaria. However, sleeping under insecticide-treated nets (ITNs), using mosquito coils/repellents, and indoor residual spraying (IRS) were not statistically significantly associated with infection.

Conclusion: Children between 0 and 5 years and those aged between 6 and 14 years continue to shoulder the highest burden of malaria. Efforts to improve housing characteristics such as installation of roofing ceiling, screening doors, and clearing potential mosquito breeding sites should be encouraged in these rapidly urbanizing areas.

References

Makenga G, Menon S, Baraka V, Minja D, Nakato S, Delgado-Ratto C . Prevalence of malaria parasitaemia in school-aged children and pregnant women in endemic settings of sub-Saharan Africa: A systematic review and meta-analysis. Parasite Epidemiol Control. 2020; 11:e00188. PMC: 7591779. DOI: 10.1016/j.parepi.2020.e00188. View

Pwalia R, Joannides J, Iddrisu A, Addae C, Acquah-Baidoo D, Obuobi D . High insecticide resistance intensity of Anopheles gambiae (s.l.) and low efficacy of pyrethroid LLINs in Accra, Ghana. Parasit Vectors. 2019; 12(1):299. PMC: 6567633. DOI: 10.1186/s13071-019-3556-y. View

Basu S, Sahi P . Malaria: An Update. Indian J Pediatr. 2017; 84(7):521-528. DOI: 10.1007/s12098-017-2332-2. View

Deribew A, Birhanu Z, Sena L, Dejene T, Reda A, Sudhakar M . The effect of household heads training on long-lasting insecticide-treated bed nets utilization: a cluster randomized controlled trial in Ethiopia. Malar J. 2012; 11:99. PMC: 3338089. DOI: 10.1186/1475-2875-11-99. View

Brenyah R, Osakunor D, Ephraim R . Factors influencing urban malaria: a comparative study of two communities in the Accra Metropolis. Afr Health Sci. 2014; 13(4):992-8. PMC: 4056473. DOI: 10.4314/ahs.v13i4.19. View

Hamid-Adiamoh M, Amambua-Ngwa A, Nwakanma D, DAlessandro U, Awandare G, Afrane Y . Insecticide resistance in indoor and outdoor-resting Anopheles gambiae in Northern Ghana. Malar J. 2020; 19(1):314. PMC: 7460795. DOI: 10.1186/s12936-020-03388-1. View

Pinchoff J, Chaponda M, Shields T, Sichivula J, Muleba M, Mulenga M . Individual and Household Level Risk Factors Associated with Malaria in Nchelenge District, a Region with Perennial Transmission: A Serial Cross-Sectional Study from 2012 to 2015. PLoS One. 2016; 11(6):e0156717. PMC: 4900528. DOI: 10.1371/journal.pone.0156717. View

Janko M, Irish S, Reich B, Peterson M, Doctor S, Mwandagalirwa M . The links between agriculture, mosquitoes, and malaria risk in children younger than 5 years in the Democratic Republic of the Congo: a population-based, cross-sectional, spatial study. Lancet Planet Health. 2018; 2(2):e74-e82. PMC: 5809714. DOI: 10.1016/S2542-5196(18)30009-3. View

Wanzirah H, Tusting L, Arinaitwe E, Katureebe A, Maxwell K, Rek J . Mind the gap: house structure and the risk of malaria in Uganda. PLoS One. 2015; 10(1):e0117396. PMC: 4311957. DOI: 10.1371/journal.pone.0117396. View

10.

Cohee L, Nankabirwa J, Greenwood B, Djimde A, Mathanga D . Time for malaria control in school-age children. Lancet Child Adolesc Health. 2021; 5(8):537-538. DOI: 10.1016/S2352-4642(21)00158-9. View

11.

Hogarh J, Antwi-Agyei P, Obiri-Danso K . Application of mosquito repellent coils and associated self-reported health issues in Ghana. Malar J. 2016; 15:61. PMC: 4743129. DOI: 10.1186/s12936-016-1126-8. View

12.

Winskill P, Rowland M, Mtove G, Malima R, Kirby M . Malaria risk factors in north-east Tanzania. Malar J. 2011; 10:98. PMC: 3094229. DOI: 10.1186/1475-2875-10-98. View

13.

Staedke S, Maiteki-Sebuguzi C . Targeting malaria control to schoolchildren. Lancet Glob Health. 2023; 11(8):e1156-e1157. DOI: 10.1016/S2214-109X(23)00238-3. View

14.

Baffour-Awuah S, Annan A, Maiga-Ascofare O, Dieudonne S, Adjei-Kusi P, Owusu-Dabo E . Insecticide resistance in malaria vectors in Kumasi, Ghana. Parasit Vectors. 2016; 9(1):633. PMC: 5142350. DOI: 10.1186/s13071-016-1923-5. View

15.

Hunt R, Fuseini G, Knowles S, Stiles-Ocran J, Verster R, Kaiser M . Insecticide resistance in malaria vector mosquitoes at four localities in Ghana, West Africa. Parasit Vectors. 2011; 4:107. PMC: 3145582. DOI: 10.1186/1756-3305-4-107. View

16.

Mathanga D, Halliday K, Jawati M, Verney A, Bauleni A, Sande J . The High Burden of Malaria in Primary School Children in Southern Malawi. Am J Trop Med Hyg. 2015; 93(4):779-789. PMC: 4596600. DOI: 10.4269/ajtmh.14-0618. View

17.

Degarege A, Fennie K, Degarege D, Chennupati S, Madhivanan P . Improving socioeconomic status may reduce the burden of malaria in sub Saharan Africa: A systematic review and meta-analysis. PLoS One. 2019; 14(1):e0211205. PMC: 6345497. DOI: 10.1371/journal.pone.0211205. View

18.

Afoakwah C, Deng X, Onur I . Malaria infection among children under-five: the use of large-scale interventions in Ghana. BMC Public Health. 2018; 18(1):536. PMC: 5913887. DOI: 10.1186/s12889-018-5428-3. View

19.

Noor A, Kirui V, Brooker S, Snow R . The use of insecticide treated nets by age: implications for universal coverage in Africa. BMC Public Health. 2009; 9:369. PMC: 2761895. DOI: 10.1186/1471-2458-9-369. View

20.

Arikawa S, Tchankoni M, Gbeasor-Komlanvi F, Atekpe S, Atcha-Oubou T, Figueroa-Romero A . Prevalence and risk factors associated with malaria infection in children under two years of age in southern Togo prior to perennial malaria chemoprevention implementation. Malar J. 2023; 22(1):357. PMC: 10664264. DOI: 10.1186/s12936-023-04793-y. View