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Malaria parasite carriage and risk determinants in a rural population: a malariometric survey in Rwanda.

Kateera F, Mens PF, Hakizimana E, Ingabire CM, Muragijemariya L, Karinda P, Grobusch MP, Mutesa L, van Vugt M - Malar. J. (2015)

Bottom Line: A malariometric household survey was conducted between June and November 2013, involving 12,965 persons living in 3,989 households located in 35 villages in a sector in eastern Rwanda.A malaria parasite carriage risk-protective effect was associated with living in households of, higher socio-economic status, where the head of household was educated and where the house floor or walls were made of cement/bricks rather than mud/earth/wood materials.Parasitaemia cases were found to significantly cluster in the Gikundamvura area that neighbours marshlands.

View Article: PubMed Central - PubMed

Affiliation: Centre of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Centre, Meibergdreef 9, Amsterdam, 1100 DE, The Netherlands. fkkateera@yahoo.com.

ABSTRACT

Background: Based on routine health facility case data, Rwanda has achieved a significant malaria burden reduction in the past ten years. However, community-based malaria parasitaemia burden and reasons for continued residual infections, despite a high coverage of control interventions, have yet to be characterized. Measurement of malaria parasitaemia rates and evaluation of associated risk factors among asymptomatic household members in a rural community in Rwanda were conducted.

Methods: A malariometric household survey was conducted between June and November 2013, involving 12,965 persons living in 3,989 households located in 35 villages in a sector in eastern Rwanda. Screening for malaria parasite carriage and collection of demographic, socio-economic, house structural features, and prior fever management data, were performed. Logistic regression models with adjustment for within- and between-households clustering were used to assess malaria parasitaemia risk determinants.

Results: Overall, malaria parasitaemia was found in 652 (5%) individuals, with 518 (13%) of households having at least one parasitaemic member. High malaria parasite carriage risk was associated with being male, child or adolescent (age group 4-15), reported history of fever and living in a household with multiple occupants. A malaria parasite carriage risk-protective effect was associated with living in households of, higher socio-economic status, where the head of household was educated and where the house floor or walls were made of cement/bricks rather than mud/earth/wood materials. Parasitaemia cases were found to significantly cluster in the Gikundamvura area that neighbours marshlands.

Conclusion: Overall, Ruhuha Sector can be classified as hypo-endemic, albeit with a particular 'cell of villages' posing a higher risk for malaria parasitaemia than others. Efforts to further reduce transmission and eventually eliminate malaria locally should focus on investments in programmes that improve house structure features (that limit indoor malaria transmission), making insecticide-treated bed nets and indoor residual spraying implementation more effective.

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Related in: MedlinePlus

Flow chart of study household/participant enrolment and malaria screening.
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Fig2: Flow chart of study household/participant enrolment and malaria screening.

Mentions: In total, 4705 households occupied by 19,925 individuals were surveyed. In the final analysis, only data from 12,965 (65%) eligible individuals (3,968 households), who had complete questionnaire and laboratory data on all covariates, were included. A flow chart of the survey process and selection of participants is detailed in Figure 2. A greater proportion of study participants were female (53.5%) and the age distribution was 15.1, 32.58 and 52.31% for age groups six to 59 months, five to 15 years and ≥16 years, respectively (Table 2).Figure 2


Malaria parasite carriage and risk determinants in a rural population: a malariometric survey in Rwanda.

Kateera F, Mens PF, Hakizimana E, Ingabire CM, Muragijemariya L, Karinda P, Grobusch MP, Mutesa L, van Vugt M - Malar. J. (2015)

Flow chart of study household/participant enrolment and malaria screening.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4308829&req=5

Fig2: Flow chart of study household/participant enrolment and malaria screening.
Mentions: In total, 4705 households occupied by 19,925 individuals were surveyed. In the final analysis, only data from 12,965 (65%) eligible individuals (3,968 households), who had complete questionnaire and laboratory data on all covariates, were included. A flow chart of the survey process and selection of participants is detailed in Figure 2. A greater proportion of study participants were female (53.5%) and the age distribution was 15.1, 32.58 and 52.31% for age groups six to 59 months, five to 15 years and ≥16 years, respectively (Table 2).Figure 2

Bottom Line: A malariometric household survey was conducted between June and November 2013, involving 12,965 persons living in 3,989 households located in 35 villages in a sector in eastern Rwanda.A malaria parasite carriage risk-protective effect was associated with living in households of, higher socio-economic status, where the head of household was educated and where the house floor or walls were made of cement/bricks rather than mud/earth/wood materials.Parasitaemia cases were found to significantly cluster in the Gikundamvura area that neighbours marshlands.

View Article: PubMed Central - PubMed

Affiliation: Centre of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Centre, Meibergdreef 9, Amsterdam, 1100 DE, The Netherlands. fkkateera@yahoo.com.

ABSTRACT

Background: Based on routine health facility case data, Rwanda has achieved a significant malaria burden reduction in the past ten years. However, community-based malaria parasitaemia burden and reasons for continued residual infections, despite a high coverage of control interventions, have yet to be characterized. Measurement of malaria parasitaemia rates and evaluation of associated risk factors among asymptomatic household members in a rural community in Rwanda were conducted.

Methods: A malariometric household survey was conducted between June and November 2013, involving 12,965 persons living in 3,989 households located in 35 villages in a sector in eastern Rwanda. Screening for malaria parasite carriage and collection of demographic, socio-economic, house structural features, and prior fever management data, were performed. Logistic regression models with adjustment for within- and between-households clustering were used to assess malaria parasitaemia risk determinants.

Results: Overall, malaria parasitaemia was found in 652 (5%) individuals, with 518 (13%) of households having at least one parasitaemic member. High malaria parasite carriage risk was associated with being male, child or adolescent (age group 4-15), reported history of fever and living in a household with multiple occupants. A malaria parasite carriage risk-protective effect was associated with living in households of, higher socio-economic status, where the head of household was educated and where the house floor or walls were made of cement/bricks rather than mud/earth/wood materials. Parasitaemia cases were found to significantly cluster in the Gikundamvura area that neighbours marshlands.

Conclusion: Overall, Ruhuha Sector can be classified as hypo-endemic, albeit with a particular 'cell of villages' posing a higher risk for malaria parasitaemia than others. Efforts to further reduce transmission and eventually eliminate malaria locally should focus on investments in programmes that improve house structure features (that limit indoor malaria transmission), making insecticide-treated bed nets and indoor residual spraying implementation more effective.

Show MeSH
Related in: MedlinePlus