Epidemiological Profile and Risk Factors for Malaria in Rural Communities Before the Operationalization of the Singrobo-Ahouaty Dam, Southern Côte d'Ivoire.

Abstract

Malaria remains a major public health issue, especially near hydroelectric dams that often promote mosquito breeding. This study aimed to establish baseline epidemiological data during the construction of the Singrobo-Ahouaty dam to support assessment and decision-making for short- and long-term health impacts on surrounding communities. A cross-sectional survey was carried out in randomly selected households. Blood samples were analyzed using thick/thin smears and rapid diagnostic tests, while sociodemographic and behavioral data were collected via questionnaires. Statistical analyses included chi-square, Mann-Whitney, Kruskal-Wallis tests, and logistic regression. The malaria prevalence was 43.1% (394/915). The parasite density averaged 405.7 parasites/µL. School-age children (6-13 years) showed the highest prevalence (74.3%, p < 0.0001), while younger children (0-5 years) had the highest parasite density (1218.0 parasites/µL, p < 0.0001). Highly elevated infection rates (>51%) occurred in Sokrogbo, N'Dènou, and Amani-Menou, with the highest density in Ahérémou 1 (5663.9 parasites/µL). Risk factors included being an informal worker (ORa = 1.5), working in the raw material sector (ORa = 1.4) or market gardening/rice farming (ORa = 0.9; p = 0.043), and frequent mosquito bites (OR = 0.4; p = 0.017). These results underscore the need for stronger vector control strategies, improved bed net distribution and follow-up, and enhanced intersectoral collaboration in dam-influenced areas to reduce malaria transmission.