Author: Martha Malasa
Citation Style For This Article: Malasa M . Factors associated with malaria transmission; a comparative study of Munyumbwe and Sompani Rural Health Centres in Gwembe district, Zambia. . Health Press Zambia Bull. 2020; 4(4); pp 19
Malaria remains a MAJOR public health problem in Zambia. Malaria hotspots pose a challenge to attaining malaria elimination by 2021. Identifying predictors of malaria in hotspots and geographically adjacent areas might reveal important information about how to achieve this goal. Munyumbwe and Sompani Rural Health Centres (RHCs) in Southern Province have been receiving the same intervention package since 2014, yet malaria incidence in 2019 were 6/1000 and 117/1000, respectively. We investigated factors associated with malaria transmission in these two RHC catchment areas.
A cross-sectional study was undertaken at Munyumbwe and Sompani RHCs, where a pre-tested structured questionnaire was administered to 340 consenting participants tested for malaria during January-February 2020. Data collected included: age; education level; malaria knowledge; insecticide-treated nets (ITN) possession and use; indoor residual spraying (IRS); travel history; index case follow-up; outdoor activities; and presence of stagnant water. Multiple logistic regression analysis was done using Stata.
At Sompani RHC, 50% (85/170) of participants had malaria during January-February 2020 compared to Munyumbwe with 5.9% (10/170) (AOR=0.22; p=0.004). Travelling outside the district at Sompani was associated with malaria (AOR=29.5; p<0.0001). In both areas, participants who utilized ITNs had reduced odds of acquiring malaria than those who never utilized (Munyumbwe: AOR=0.03 p=0.042; Sompani: AOR=0.11, p=0.006). Index case follow-up was lower in Sompani (6%) than Munyumbwe (90%) (p<0.0001)
Travelling outside the district for Sompani was a unique predictor of malaria. Most people who had malaria in Sompani reported having travelled to high malaria burden areas. Additionally, only a minority of index cases are followed up in Sompani, in contrast to Munyumbwe. Providing malaria prophylaxis to travellers and strengthening index case follow-up are potential strategies to control malaria in Sompani and possibly elsewhere in Zambia.