Presence of asymptomatic malaria infection and living conditions in lowland Ethiopia: a community cross-sectional study | Infectious diseases of poverty

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The main determinants of the epidemiology of vector-borne diseases are the variation in the level of vulnerability of the specific population. Living conditions are the main factors that determine the vulnerability to malaria of a given population. In the present study, the characteristics of living conditions such as the quality of housing (types of walls, roof, floor); location of the kitchen (outdoor, indoor with or without separation); energy source; drinking water source; overnight with livestock and socio-demographic variables were tested. The argument is whether the living conditions given above could increase the likelihood of asymptomatic malaria infection by increasing entry of vector mosquitoes, indoor resting, biting and contributing to malaria transmission . The results of this research revealed that living conditions such as type of house wall, overnight stay with livestock in the same house, and kitchen location were significantly associated with the prevalence of malaria infection. asymptomatic.

According to the results of this research, the association between prevalence of asymptomatic malaria and housing structure showed that better housing was associated with a reduced likelihood of asymptomatic malaria and it is an effective complement to vector control strategies. The prevalence of asymptomatic malaria infection among occupants living in houses constructed with a traditional floor/wall/roof ranges from 8.1% to 8.4%, while it ranges from 2.0% to 4.6 % among those living in modern floor/wall/roof houses. It was 4.3 times higher among occupants of a house built with traditional wall materials (natural or rudimentary) than among occupants of a house built with modern wall materials (finished cement or brick).

Previous results on the association between malaria infection and housing quality indicated that the prevalence of malaria among occupants of houses built with traditional materials was 8.8% while it ranged from 1.4 to 1 .6% among occupants living in houses built with modern materials. the current study [27, 28]. The significant association between housing quality and asymptomatic malaria infection found in this study was supported by studies conducted in southern Zambia, Uganda, Swaziland, northern Botswana and a series of papers from work on the quality of housing in Africa. [16, 27,28,29,30].

In the present study, spending nights with cattle in the same house was significantly associated with an increase in asymptomatic malaria infection. The frequency of asymptomatic malaria infection was 5.6 times higher in individuals who spent their nights with their livestock than in those who did not. This may be due to the attractive nature of livestock to zoophilic and opportunistic household vector mosquitoes and once they enter households, the opportunistic mosquito prefers to bite human skin as it is easy for their proboscis. Results from a previous study conducted in southern Ethiopia and Indonesia on the association of malaria infection and keeping medium-sized animals in the same house with family members supported the results of this study and showed a 3 times higher risk of contracting a malaria infection. [17, 19].

The location of the kitchen was classified as being outside the main house, separate rooms in the main house and in the main house without separation, and analyzed for association with asymptomatic malaria infection. In the logistic regression model analysis, the likelihood of the kitchen being located in the main house without separation was more than twice that of households that kept their kitchen outside the main house. This association may be due to the location of the kitchen serving as a proxy for resting indoors in households during smoke-free hours. This finding was supported by a study of children in the Ethiopian highlands. [21].

Strength and limitations of the study

The strength of the study includes the generalizability to similar lowland areas on the African continent and the representativeness of the study area (selection of districts from three different regions that have similar characteristics (altitude, weather, water bodies and malaria burden). study, respectively. Adjustments for confounding factors were also applied during data analysis.

Although this is one of the few studies that have attempted to determine the association between asymptomatic malaria infection and overall living conditions, it should be interpreted with caution as there are some limitations. For example, he applied observational studies, limiting causal implications between asymptomatic malaria carriers and living conditions. Additionally, we could not directly show the association between asymptomatic malaria infection and the number of holes, cracks, open doors, or eaves because we did not collect information. We recommend that future studies include the association of the number of holes and fissures with the prevalence of asymptomatic malaria.

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