Population, behavioural and environmental drivers of malaria prevalence in the Democratic Republic of Congo

Abstract

BackgroundMalaria is highly endemic in the Democratic Republic of Congo (DRC), but the limits and intensity of transmission within the country are unknown. It is important to discern these patterns as well as the drivers which may underlie them in order for effective prevention measures to be carried out.MethodsBy applying high-throughput PCR analyses on leftover dried blood spots from the 2007 Demographic and Health Survey (DHS) for the DRC, prevalence estimates were generated and ecological drivers of malaria were explored using spatial statistical analyses and multilevel modelling.ResultsOf the 7,746 respondents, 2268 (29.3%) were parasitaemic; prevalence ranged from 0-82% within geographically-defined survey clusters. Regional variation in these rates was mapped using the inverse-distance weighting spatial interpolation technique. Males were more likely to be parasitaemic than older people or females (p < 0.0001), while wealthier people were at a lower risk (p < 0.001). Increased community use of bed nets (p = 0.001) and community wealth (p < 0.05) were protective against malaria at the community level but not at the individual level. Paradoxically, the number of battle events since 1994 surrounding one's community was negatively associated with malaria risk (p < 0.0001).ConclusionsThis research demonstrates the feasibility of using population-based behavioural and molecular surveillance in conjunction with DHS data and geographic methods to study endemic infectious diseases. This study provides the most accurate population-based estimates to date of where illness from malaria occurs in the DRC and what factors contribute to the estimated spatial patterns. This study suggests that spatial information and analyses can enable the DRC government to focus its control efforts against malaria.

Epidemiological Aspects of Malaria in Pregnant Women: Prevalence and Risk Factors in Mwene Ditu, DR Congo

“…Our findings are consistent with a study conducted in the DRC by the Messina team [28] who estimated that malaria is a disease of poverty because wealth could protect people against malaria: wealthy families were able to have access to higher levels of awareness, education and prevention of malaria with the same possibility of buying antimalarial drugs that can reduce the rate of malaria infection and thus live in better housing conditions.…”

Malaria, clinical features and acute crisis in children suffering from sickle cell disease in resource-limited settings: a retrospective description of 90 cases

“…This last situation is due to cultural beliefs, poverty, and ignorance. 5 In addition, many patients had started anti-malarial treatment at home before their admission to our institution. Malaria as a cause for transfusion and hospitalization in this population is found to be important.…”

Spatial and social factors drive anemia in Congolese women

“…Although the bivariate analyses in Table 3 suggest that malaria parasitemia may be associated with anemia, its lack of statistical significance in the multivariate models indicates that other factors are more important in accounting for anemia prevalence. An overall 29.3% malaria parasitemia prevalence was found across the DRC in 2007, with some areas exhibiting up to 82% prevalence (Messina et al, 2011). This is comparable to rates of peripheral malaria found in pregnant women across all of sub-Saharan Africa (32%, (Chico et al, 2012)), but a direct comparison between this rate and rates of anemia across sub-Saharan Africa have not been made.…”