Abstract
BackgroundMalaria prevalence and transmission intensity in Tanzania is heterogeneous with spatial and temporal variations between geographical areas and ecological systems. The objective of this study was to determine the prevalence of malaria, anaemia and nutritional status in relation to livelihoods, ecosystem and health systems in Kilosa District in central Tanzania.MethodsThis study was conducted in four villages, two characterised by rice irrigation ecosystem and the other two by dry savannah ecosystem and pastoral livelihoods. In each ecosystem, one of the villages had a healthcare facility. Schoolchildren were screened for malaria infection using malaria rapid diagnostic test (mRDT) and microscopy and they were assessed for their anaemia and nutritional statuses.ResultsA total of 1,019 school children (age = 4–16 years) were screened for malaria infection. The overall prevalence of Plasmodium falciparum infection was 10.6 % and 4.5 % by mRDT and microscopy, respectively. Children from pastoral villages had lower (2.9 %) prevalence of malaria than their counterparts (18.2 %) in the rice irrigation villages. A significantly high risk of malaria was observed among children in rice irrigation than in the pastoral ecosystem (OR: 0.13; 95%CI 0.07, 0.23). Children living in areas with health care facilities had a low odd of malaria infection by 45 % (OR: 0.55; 95 % CI = 0.35, 0.86). Overall, the prevalence of anaemia in the district was 43.4 % (n = 775); and 58.3 % of those with severe anaemia were among children from the pastoral villages. Anaemia was significantly higher among children not using mosquito nets (p = 0.049); and among those with malaria infection (p <0.001). The majority (96 %) of the children had Body Mass Index less than 18.5 kg/m2 which indicate high proportion of underweight.ConclusionThere are significant variations in the risk of acquiring malaria infection between different ecosystems and livelihoods. These findings suggest that malaria control programmes must take into account ecosystems and livelihoods of the targeted population through an integrated management of malaria and nutrition approach.
Highlights
Malaria prevalence and transmission intensity in Tanzania is heterogeneous with spatial and temporal variations between geographical areas and ecological systems
Anaemia was significantly higher among children not using mosquito nets (45.6 % vs. 39.6 %, p-value = 0.049); and among those with malaria infection (57.3 % vs. 39.1 %; p-value < 0.001)
The findings of this study indicate that children from rice irrigation villages had higher prevalence of malaria than their counterparts in the pastoral villages
Summary
Malaria prevalence and transmission intensity in Tanzania is heterogeneous with spatial and temporal variations between geographical areas and ecological systems. There are variations in malaria mosquito vector composition and transmission intensities in localised areas, within districts and even within villages. The significant variations in malaria transmission intensities and prevalence are associated with variations in ecological systems [4,5,6,7] and socio-economic factors [8, 9]. In spite of the many past and current efforts to combat malaria, the disease has remained a major public health problem in Tanzania for various reasons including human sociocultural factors, inequity, weak health systems, limited budgets, poor governance and accountability, antimalarial drug and insecticide resistance, environmental changes and demographic factors [1]
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