ArticleMalaria journal2025
Sociodemographic and ecological factors associated with malaria and malaria recurrence risk in children in Msambweni, Kwale County, Kenya.
Article in Malaria journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Malaria among children living in flood-prone villages in the Kasese District of Western Uganda: prevalence and risk factors from a cross-sectional study.Research square · 2026Article
- Sociodemographic and socioeconomic predictors of asymptomatic malaria among children and adolescents in rural Guinea: a longitudinal study.Frontiers in public health · 2026Article
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Abstract
backgroundMalaria remains a major public health issue where poverty and inadequate healthcare infrastructure intersect. This study assessed sociodemographic and ecological factors influencing malaria risk in Msambweni, Kwale County, Kenya.
methodsA child cohort (aged 1-18 years) presenting with acute febrile illness at Msambweni County Referral Hospital from 2014 to 2018 was enrolled, supplemented by a nested case-control study. Data were collected through caregiver interviews and household observations. Malaria was diagnosed by light microscopy (Giemsa-stained thick and thin smears). Recurrent malaria was defined as ≥ 2 confirmed infections within the study period.
resultsThere were 2610 febrile illness visits by 2371 children; 40.6% (1059/2610) had malaria parasitaemia. A single visit occurred among 2169/2371 (91.5%), while 174, 19 and 9 children made two, three and four visits, respectively. Overall, 992/2371 (41.8%, 95%CI 39.8-43.9%) children experienced malaria, and 60/2371 (2.5%, 95%CI 1.9-3.2) had recurrent malaria; 51 had one, 8 had two and 1 had three recurrent episodes. In multivariable analysis, malaria risk was associated with older age (2-5 vs. < 2 years: aRR 1.38 [95%CI 1.09-1.75]; ≥ 5 vs. < 2 years: aRR 1.57 [95%CI 1.23-2.00]). Protective factors included higher maternal education (secondary and above: aRR 0.66 [95%CI 0.50-0.87]), piped/well water inside the compound (aRR 0.78 [95%CI 0.65-0.94]), and electricity/solar lighting (aRR 0.61 [95%CI 0.50-0.74]). Recurrent malaria was linked to poor-quality housing, particularly dirt floors and proximity to mosquito breeding sites such as rice fields. Increased malaria risk was also associated with poor ventilation and limited windows. DISCUSSION: Targeted vector control near rice fields and consistent use of insecticide-treated nets remain crucial. Housing improvements, including window screening and better roofing, may reduce mosquito-human contact. The shift toward increased malaria among school-aged children highlights the need to strengthen interventions targeting this group.
conclusionsInvestments in housing, maternal education, and WASH infrastructure can enhance malaria control efforts and strengthen existing interventions.
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