Abstract
BackgroundMalaria is one of the most severe public health issues that result in massive morbidity and mortality in most countries of the sub-Saharan Africa (SSA). This study aimed to determine the scope of household, accessibility to malaria care and factors associated with household malaria in the Democratic Republic of Congo (DRC).MethodsThis was a community-based cross-sectional study conducted in an urban and a rural sites in which 152 households participated, including 82 urban and 70 rural households (1029 members in total). The ‘malaria indicator questionnaire’ (MIQ) was anonymously answered by household heads (respondents), reporting on malaria status of household members in the last 12 months.ResultsThere were 67.8% of households using insecticide-treated bed nets (ITN) only, 14.0% used indoor residual spraying (IRS) only, 7.3% used ordinary bed nets (without insecticide treatment), 1.4% used mosquito repelling cream, 2.2% combined ITN and IRS, whereas 7.3% of households did not employ any preventive measure; p < 0.01). In addition, 96.7% of households were affected by malaria (at least one malaria case), and malaria frequency per household was relatively high (mean: 4.5 ± 3.1 cases reported) in the last 12 months. The mean individual malaria care expenditure was relatively high (101.6 ± 10.6 USD) in the previous 12 months; however, the majority of households (74.5%) earned less than 50 USD monthly. In addition, of the responders who suffered from malaria, 24.1% did not have access to malaria care at a health setting. Furthermore, a multivariate analysis with adjustment for age, education level and occupation showed that household size (OR = 1.43 ± 0.13; 95% CI 1.18–1.73; p < 0.001), inappropriate water source (OR = 2.41 ± 0.18; 95% CI 1.17–2.96; p < 0.05) absence of periodic water, sanitation and hygiene (WASH) intervention in residential area (OR = 1.63 ± 1.15; 95% CI 1.10–2.54; p < 0.05), and rural residence (OR = 4.52 ± 2.47; 95% CI 1.54–13.21; p < 0.01) were associated with household malaria.ConclusionThis study showed that household size, income, WASH status and rural site were malaria-associated factors. Scaling up malaria prevention through improving WASH status in the residential environment may contribute to reducing the disease burden.
Highlights
Malaria is one of the most severe public health issues that result in massive morbidity and mortality in most countries of the sub-Saharan Africa (SSA)
Recent reports from the World Health Organization (WHO) show progress made by several countries in reducing malaria burden, with a decline in preventable child deaths over the 15-year period of the implementation of millennium development goals (MDGs)
Characteristics of the households and the respondents Of the 181 survey questionnaires distributed to household heads, 152 (83.9%) were returned; 51.3% of respondents were males and 48.7% females
Summary
Malaria is one of the most severe public health issues that result in massive morbidity and mortality in most countries of the sub-Saharan Africa (SSA). Recent reports from the World Health Organization (WHO) show progress made by several countries in reducing malaria burden, with a decline in preventable child deaths over the 15-year period of the implementation of millennium development goals (MDGs). Malaria is an infectious disease that continues to pose a major health challenge; it is still endemic in 97 countries, including the Democratic Republic of Congo (DRC) where only 56% of children under age five sleep under insecticide-treated bed nets [2,3,4]. In several malaria-affected countries, scale-up interventions are being implemented to reduce the disease burden, such as long-lasting insecticide-treated nets (LLIN), indoor residual spraying (IRS), rapid diagnostic tests (RDT) and artemisininbased combination treatment (ACT). Many of high malaria burden countries such as Nigeria and DRC have been reporting significant increases in disease cases [4], suggesting the necessity for further research that could culminate in the discovery of new strategies for malaria control
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