Family or friends?: individual and neighborhood predictors of malaria across seasons in the Democratic Republic of Congo

Authors: Margaret Carrel*, University of Iowa
Topics: Medical and Health Geography
Keywords: malaria, Democratic Republic of the Congo, neighborhood
Session Type: Paper
Day: 4/10/2018
Start / End Time: 12:40 PM / 2:20 PM
Room: Lafayette, Marriott, River Tower Elevators, 41st Floor
Presentation File: No File Uploaded


Many studies of malaria are cross-sectional in nature and cannot assess how malaria prevalence changes over time and what predicts changes in an individual’s malaria status, such as changing malaria in the household or immediate neighborhood. We present data from a prospective, longitudinal study in seven sites in the Democratic Republic of the Congo. Rapid diagnostic tests (RDT) and PCR tests for malaria are paired with detailed questionnaire data on individual behaviors and household socioecological characteristics at baseline enrollment and during four follow-up visits. Time-series hierarchical models are used to understand what individual and household characteristics predict malaria across seasons. We find that both malaria among other household members and above-average malaria prevalence in a small neighborhood around the household are positive predictors for individual malaria outcomes, after controlling for factors such as age, bednet usage and wealth. Further, there is elevated risk of malaria across seasons when individuals reside near vector breeding sites such as marshes. Such findings suggest that successful malaria intervention and elimination strategies should focus on targeting entire households and neighborhoods rather than focusing on specific age or risk (i.e. pregnant women) groups. Additionally, these interventions should focus on groups of households living in close proximity environments with elevated risk of vector interaction.

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