SOCIO-ENVIRONMENTAL DETERMINANTS OF MALARIA TRANSMISSION IN URBAN AREAS: A CASE STUDY FROM KISANGANI, DRC

Abstract

Introduction: Malaria remains hyper-endemic in the city of Kisangani due to environmental factors favorable to mosquito vectors and complex socio-economic conditions. The aim of this study was to identify the socio-economic and environmental factors contributing to high malaria transmission in Kisangani. Methods: An analytical cross-sectional study was carried out from December 1, 2023 to May 15, 2024 in 402 households in Kisangani. Data were collected using the KoboCollect platform, and blood samples were taken from children (791) and pregnant women (135). The ORb and Pearson chi-square tests were used to investigate associations with potential risk factors. Results: Environmental conditions favorable to the development of vectors were observed around households (22%), represented essentially by the presence of refuse (80%) and puddles (68%). The low level of education of the head of household and the low level of household income were associated with an environment favorable to malaria transmission (p<0.05), and a sanitized environment is a protective factor against malaria (p<0.001). The prevalence of malaria was about 5 times higher in pregnant women than in children aged 0-59 months, and the prevalence of Plasmodium falciparum was equal between RDT and EW results, with Plasmodium falciparum being the predominant species. Conclusion: This study highlighted the importance of socio-economic and environmental determinants in malaria transmission in Kisangani. Targeted interventions are needed to improve living conditions and reinforce prevention practices, particularly among the most vulnerable populations.