A HEALTH FACILITY-BASED ASSESSMENT OF MALARIA RISK FACTORS IN URBAN MAPUTO, MOZAMBIQUE Open Access
Schmidt, Lisa Marie (2011)
Abstract
Background: Urbanization of sub-Saharan Africa has a major
impact on malaria
epidemiology. While much is known about malaria in rural areas of
Mozambique, there
is a lack of knowledge concerning urban malaria patterns. Malaria
research and control
strategies are based largely on experience gained in rural areas
and need to be adapted
to the urban environment. This study was done to determine malaria
prevalence and
risk factors in Maputo City.
Methods: A health-facility based survey was conducted to
investigate the proportion of
laboratory-confirmed malaria in patients presenting with fever or
history of fever in
Maputo, Mozambique. A total of 643 patients from 28 health
facilities were analyzed in
the study; each completed a questionnaire on malaria risk factors
and gave a blood
sample for microscopy and rapid diagnostic tests (RDTs). Logistic
regression models
were used to estimate the effect of potential malaria risk factors.
Two potential
confounders, travel outside Maputo City and bednet usage, were also
incorporated into
logistic regression models to control for their effect on an
individual's risk of malaria.
Results: There were 103 (16.0%) patients who had a positive blood
slide for malaria.
When stratified by health facility location, the proportions were
10.1% (26/257), 15.1%
(26/172), and 23.8% (51/214) in urban, peri-urban, and rural
facilities, respectively. Risk
factors that were significantly associated with malaria included:
age greater than five
years, documented fever at enrollment, living near a farm, health
facility location, and
living near water.
Conclusion: There is a high prevalence of malaria among febrile
patients presenting to
health facilities in Maputo. Prevention strategies should target
adults as well as children
and both urban and rural areas of the city should be addressed in
malaria control
interventions.
Table of Contents
Table of Contents
Background - 1
Introduction - 5
Methods - 7
Analysis - 10
Results - 13
Discussion - 17
References - 23
Tables and Figures - 28
Appendix - 32
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