Investigating seroprevalence and vulnerability in a flood-affected internally displaced population: A cross-sectional study

Abstract

Background Malaria is a communicable disease that affects millions of people throughout the world every year. Internally displaced people are a vulnerable group that can be disproportionately affected by mosquito-transmitted disease. Harsh climatic conditions such as floods are among the key factors that directly contribute to the displacement of people while simultaneously creating favourable breeding grounds for mosquitoes that transmit Plasmodium species. This study aimed to assess the epidemiological aspects of malaria transmission in flood-affected displaced people. Methods A cross-sectional study was conducted among the internally displaced persons, displaced by the 2022 floods in Pakistan, living in the ‘Tent City’ of Hyderabad, Sindh. A total of 2,640 participants were recruited from the camp via random sampling. Rapid diagnostic tests and microscopy techniques were utilized to assess blood samples, and a standardized questionnaire was used to gather demographic data. The seroprevalence of malarial infection and its subtypes was determined. Vulnerability to infection based on sex and age group was also assessed using stratified analysis. Results Of the 2640 participants, 354 (13.4%) were malaria positive. Rapid diagnostic tests showed a marginally greater (14.8%) seroprevalence than did microscopy (10.7%). Plasmodium vivax was found to be the predominant Plasmodium species among the displaced people, accounting for 87.5% of the total cases, followed by Plasmodium falciparum at 12.5%. Age-stratified analysis revealed that children under 12 years of age and pregnant women had a significantly greater risk of infection. The odds of becoming infected at < 12 years of age were 5.28 times greater than those at > 12 years of age. Similarly, the odds of malaria infection in pregnant women are approximately 2.17 times greater than in individuals above 12 years of age. Conclusion Malaria remains a significant hazard for internally displaced persons, with a high prevalence of malaria infection, indicating the need for prompt healthcare interventions, additional services, and preventative measures. The changing climate conditions pose a risk of increased frequency and intensity of floods leading to mass displacements. This necessitates a stronger effort to mitigate and manage such health disasters in the future.