Abstract
BackgroundThe socioeconomic and sociodemographic situation are important components for the design and assessment of malaria control measures. In malaria endemic areas, however, valid classification of socioeconomic factors is difficult due to the lack of standardized tax and income data. The objective of this study was to quantify household socioeconomic levels using principal component analyses (PCA) to a set of indicator variables and to use a classification scheme for the multivariate analysis of children < 15 years of age presented with and without malaria to an outpatient department of a rural hospital.MethodsIn total, 1,496 children presenting to the hospital were examined for malaria parasites and interviewed with a standardized questionnaire. The information of eleven indicators of the family's housing situation was reduced by PCA to a socioeconomic score, which was then classified into three socioeconomic status (poor, average and rich). Their influence on the malaria occurrence was analysed together with malaria risk co-factors, such as sex, parent's educational and ethnic background, number of children living in a household, applied malaria protection measures, place of residence and age of the child and the mother.ResultsThe multivariate regression analysis demonstrated that the proportion of children with malaria decreased with increasing socioeconomic status as classified by PCA (p < 0.05). Other independent factors for malaria risk were the use of malaria protection measures (p < 0.05), the place of residence (p < 0.05), and the age of the child (p < 0.05).ConclusionsThe socioeconomic situation is significantly associated with malaria even in holoendemic rural areas where economic differences are not much pronounced. Valid classification of the socioeconomic level is crucial to be considered as confounder in intervention trials and in the planning of malaria control measures.
Highlights
The socioeconomic and sociodemographic situation are important components for the design and assessment of malaria control measures
Additional socioeconomic factors assessed in the Demographic and Health Survey 2008 and not considered here are marital status and religion, which we did not found appropriate in the context of the study
The analysis showed that, in an area of high endemicity, the proportion of malaria in children presented to a hospital is markedly influenced by the socioeconomic status of the family: children from households classified as poor had a significantly higher chance to get malaria
Summary
The socioeconomic and sociodemographic situation are important components for the design and assessment of malaria control measures. In Ghana, where the study was conducted, malaria is prevalent during the entire year and accounts for about 32-42% of all outpatient admissions and for major inpatient causes of death [5]. Sociodemographic factors such as ethnic group, parent’s education and occupation, use of protective measures, and living standard of the family are suggested to be important risk factors for malaria and malaria epidemics [6,7,8]. The impact of socioeconomic factors, namely the family’s financial situation, is difficult to assess due to the lack of standardized economic data of income and tax. Additional socioeconomic factors assessed in the Demographic and Health Survey 2008 and not considered here are marital status and religion, which we did not found appropriate in the context of the study
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