A HEALTH FACILITY-BASED ASSESSMENT OF MALARIA RISK FACTORS IN URBAN MAPUTO, MOZAMBIQUE Open Access

Schmidt, Lisa Marie (2011)

Permanent URL: https://etd.library.emory.edu/concern/etds/k35695010?locale=pt-BR%2A
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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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