Assessing malaria risk at night-time venues in a low-transmission setting: A time-location sampling study in Zambezi, Namibia
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Date
2011
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Abstract
Background:Identifying efficient and effective strategies to reach and monitor populations at greatest risk of malaria in low-transmission settings is a key challenge for malaria elimination. In Namibia’s Zambezi Region, transmis-sion is ongoing yet its drivers remain poorly understood. A growing literature suggests that night-time social activities may lead to malaria exposure that is beyond the reach of conventional preventive interventions, such as insecticide treated bed nets and indoor residual spraying.Methods:Formative research was conducted with community members in March, 2015 in the catchment areas of six randomly selected health facilities in the western Zambezi Region to identify night-time locations where large numbers of individuals regularly congregate. Using time-location sampling, a survey was conducted between March and May, 2015 at community-identified venues (bars and evening church services) to develop representative esti-mates of the prevalence of parasite infection and risk factors among venue-goers.Results:When compared to a contemporaneous household survey of the general population aged 15 and older (N =1160), venue-goers (N =480) were more likely to have spent the night away from their home recently (17.3% vs. 8.9%, P =0.008), report recent fever (65.2% vs. 36.9%, P < 0.001), and were less likely to have sought care for fever (37.9% vs. 52.1%, P =0.011). Venue-goers had higher, but not significantly different, rates of malaria infection (4.7% vs. 2.8%, P =0.740). Risk factors for malaria infection among venue-goers could not be determined due to the small number of infections identified, however self-reported fever was positively associated with outdoor livelihood activi-ties (adjusted odds ratio [AOR] =1.9, 95% CI 1.0–3.3), not wearing protective measures at the time of the survey (AOR =6.8, 9% CI 1.4–33.6) and having been bothered by mosquitos at the venue (AOR =2.7, 95% CI 1.5–4).Conclusions:Prevention measures and continued surveillance at night-time venues may be a useful complement to existing malaria elimination efforts.
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Keywords
Malaria, High risk population
Citation
Jacobson, J.O., Smith, J.L., Cueto, C., et al. (2019). Assessing malaria risk at night-time venues in a low-transmission setting: a time-location sampling study in Zambezi, Namibia. Malaria Journal, 18(179), 1-11.