Factors Associated With Plasmodium falciparum Infection Transmission in Artisanal Mining and Mining-Free Communities: The Case of Fanteakwa South District, Ghana.

Abstract

Artisanal mining in the Fanteakwa South District (FSD) of Ghana has created stagnant water bodies that promote mosquito breeding. This study examined Plasmodium falciparum transmission dynamics in mining and nonmining communities. Using stratified sampling, three mining communities and one nonmining community were selected. Blood samples (2 mL) were collected from residents, dried blood spots were prepared, and P. falciparum ssrRNA was detected through nested PCR. The study enrolled 341 participants, including 240 (70.4%) from artisanal mining communities and 101 (29.6%) from a mining-free community. Overall, asymptomatic P. falciparum prevalence was 53.1%, significantly higher in mining communities (64.6%) than in the mining-free community (27.7%, p < 0.001). In mining areas, risk factors included being female (AOR = 2.23, p = 0.004), unmarried adult (AOR = 3.87, p < 0.001), schooling (AOR = 2.32, p = 0.005), not having mosquito nets (AOR = 2.3, p = 0.0024), using nets from open markets (AOR = 4.2, p = 0.001), net sharing (AOR = 3.0, p = 0.019), especially three people per net (AOR = 4.9, p = 0.024), and staying outdoors at night for >2 h (AOR = 8.4, p < 0.001). In the mining-free community, transmission was associated with being a child (AOR = 7.0, p = 0.024), schooling (AOR = 3.48, p = 0.014), using open-market nets (AOR = 5.67, p = 0.037), net sharing (AOR = 4.7, p = 0.028), and poor housing quality (AOR = 4.7, p = 0.003). The high odds ratios observed for factors such as prolonged outdoor night-time exposure, net sharing, use of substandard nets, and poor housing highlight concentrated risks for P. falciparum transmission. In addition, they signal priority areas where targeted interventions, such as quality-assured ITN distribution, behaviour change communication, and housing improvements, would have the greatest impact.