Identifying populations at high risk of malaria: a mixed-methods case-control study to inform targeted interventions in Senegal.

IF 2.4 3区 医学 Q3 INFECTIOUS DISEASES
Tidiane Thiam, Demba Kande, Henry Ntuku, Caterina Guinovart, Natalie Galles, Laura Merriman, Moustapha Cissé, Abiboulaye Sall, Ndack Diop, Aichatou Barry Diouf, Mama Moussa Diaw, Mamadou Diop, Baba Camara, Niene Seck, Aliou Ndour, Yakou Dieye, Jennifer Smith, Adam Bennett
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引用次数: 0

Abstract

Background: Senegal has made significant progress in reducing the burden of malaria, but transmission remains highly heterogeneous, with specific population subgroups likely at higher risk. Consultations with the National Malaria Control Programme (NMCP) and a review of available data identified nomadic pastoralists, gold miners, and Koranic school students as potential high-risk populations (HRPs). This study aimed to evaluate whether these populations are at higher risk of malaria and better characterize their exposure patterns to inform the design of targeted intervention strategies.

Methods: A mixed-methods study was conducted in the districts of Ranérou, Kaolack, and Saraya between November 2020 and December 2021. A formative assessment including key informant interviews (KII) and focus group discussions (FGD) was conducted with non-HRP and HRP members (nomadic pastoralists, gold miners, Koranic school students). A health facility-based case-control study was then conducted in nine health facilities across the three districts. 501 confirmed malaria cases and 1002 non-malaria controls were frequency matched by age and sex with a ratio of 1:2. A standardized questionnaire was administered to collect sociodemographic information, including occupation, use of malaria prevention measures, mosquito exposure, and travel history. Multivariable logistic regression was used to identify malaria risk factors.

Results: KIIs and FGDs indicated that nomadic pastoralists, gold miners and Koranic school students have high exposure to mosquito bites through outdoor sleeping, spending time outside at night and sleeping in informal structures, with important gaps in the coverage of indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs) and limited access to health services. Compared to controls, cases had higher odds of being a nomadic pastoralist (odds ratio (OR) 4.67 95% CI 1.96-11.11) or gold miner (OR 1.92 95% CI 1.20-3.07). No evidence was found of an association with being a Koranic school student (OR 1.39 95% CI 0.80-2.39).

Conclusions: Nomadic pastoralists and gold miners in the study areas are at higher risk of malaria. Targeted interventions are needed to cover gaps in malaria prevention coverage and access to health services.

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来源期刊
Malaria Journal
Malaria Journal 医学-寄生虫学
CiteScore
5.10
自引率
23.30%
发文量
334
审稿时长
2-4 weeks
期刊介绍: Malaria Journal is aimed at the scientific community interested in malaria in its broadest sense. It is the only journal that publishes exclusively articles on malaria and, as such, it aims to bring together knowledge from the different specialities involved in this very broad discipline, from the bench to the bedside and to the field.
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