Are there geographic and socio-economic differences in incidence, burden and prevention of malaria? A study in southeast Nigeria

Obinna Onwujekwe,Chijioke Okoli,Benjamin Uzochukwu,Soludo Eze,Nkem Dike,Ogoamaka Chukwuogo

doi:10.1186/1475-9276-8-45

Abstract

RationaleIt is not clearly evident whether malaria affects the poor more although it has been argued that the poor bear a very high burden of the disease. This study explored the socioeconomic and geographic differences in incidence and burden of malaria as well as ownership of mosquito nets.MethodsStructured questionnaires were used to collect information from 1657 respondents from rural and urban communities in southeast Nigeria on: incidence of malaria, number of days lost to malaria; actions to treat malaria and household ownership of insecticide treated and untreated mosquito nets. Data was compared across socio-economic status (SES) quartiles and between urban and rural dwellers.ResultsThere was statistically significant urban-rural difference in malaria occurrence with malaria occurring more amongst urban dwellers. There was more reported occurrence of malaria amongst children and other adult household members in better-off SES groups compared to worse-off SES groups, but not amongst respondents. The average number of days that people delayed before seeking treatment was two days, and both adults and children were ill with malaria for about six days. Better-off SES quartile and urban dwellers owned more mosquito nets (p < 0.05) (treated and untreated).ConclusionMalaria occurs more amongst better-off SES groups and urban dwellers in southeast Nigeria. Deployment of malaria control interventions should ensure universal access since targeting the poor and other supposedly vulnerable groups may exclude people that really require malaria control services.

Highlights

Malaria has frequently been linked with poverty and reducing the burden of malaria is increasingly becoming a global priority [1]
Unlike previous studies that found that wealthier households were more likely to seek care or advice for malaria [1], the results showed that all socio-economic status (SES) groups as well as people living in urban and rural areas sought treatment when they had self reported malaria
There were mixed SES group and geographic differences in incidence of self reported malaria in this study, with the better-off SES groups in general reporting more malaria than worse-off SES groups, and with more malaria reported in urban areas compared to the rural areas

Summary

Introduction

Malaria has frequently been linked with poverty and reducing the burden of malaria is increasingly becoming a global priority [1]. Malaria is one of the leading causes of mortality and morbidity in Nigeria and affects children under 5 years [2]. Almost 3% of disability adjusted life years are due to malaria mortality globally, 10% in Africa [3]. The economic burden of malaria illness on households accounts for almost 50% of total economic burden of illnesses in malaria holo-endemic communities [4,5,6,7]. Living in malaria-endemic regions places an economic burden on households even if they do not suffer an episode of malaria and reducing malaria improves households' living standards [8]. It has been noted that poor people bear a disproportionate burden of the disease and have poor health seeking habits [9,10,11,3,12]

Methods

Results

Discussion

Conclusion