title: Rapid urban malaria appraisal (RUMA) I: epidemiology of urban malaria in Ouagadougou.
abstract: BACKGROUND
  Rapid urbanization in sub-Saharan Africa has a major impact on malaria epidemiology. While much is known about malaria in rural areas in Burkina Faso, the urban situation is less well understood.
  
  
  METHODS
  An assessment of urban malaria was carried out in Ouagadougou in November -December, 2002 during which a rapid urban malaria appraisal (RUMA) was applied.
  
  
  RESULTS
  The school parasitaemia prevalence was relatively high (48.3%) at the cold and dry season 2002. Routine malaria statistics indicated that seasonality of malaria transmission was marked. In the health facilities, the number of clinical cases diminished quickly at the start of the cold and dry season and the prevalence of parasitaemia detected in febrile and non-febrile cases was 21.1% and 22.0%, respectively. The health facilities were likely to overestimate the malaria incidence and the age-specific fractions of malaria-attributable fevers were low (0-0.13). Peak prevalence tended to occur in older children (aged 6-15 years). Mapping of Anopheles sp. breeding sites indicated a gradient of endemicity between the urban centre and the periphery of Ouagadougou. A remarkable link was found between urban agriculture activities, seasonal availability of water supply and the occurrence of malaria infections in this semi-arid area. The study also demonstrated that the usage of insecticide-treated nets and the education level of family caretakers played a key role in reducing malaria infection rates.
  
  
  CONCLUSIONS
  These findings show that determining local endemicity and the rate of clinical malaria cases are urgently required in order to target control activities and avoid over-treatment with antimalarials. The case management needs to be tailored to the level of the prevailing endemicity.
authors.affiliation: Swiss Tropical Institute, CH-4002 Basel, Switzerland. Shrjie.wang@unibas.ch
authors.forename: Shr-Jie
authors.initials: SJ
authors.lastname: Wang
authors.forename: Christian
authors.initials: C
authors.lastname: Lengeler
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Smith
authors.forename: Penelope
authors.initials: P
authors.lastname: Vounatsou
authors.forename: Diallo A
authors.initials: DA
authors.lastname: Diadie
authors.forename: Xavier
authors.initials: X
authors.lastname: Pritroipa
authors.forename: Natalie
authors.initials: N
authors.lastname: Convelbo
authors.forename: Mathieu
authors.initials: M
authors.lastname: Kientga
authors.forename: Marcel
authors.initials: M
authors.lastname: Tanner
mesh_terms: D000962:Antimalarials / Q000627:therapeutic use; D002050:Burkina Faso / Q000453:epidemiology; D006801:Humans; D008288:Malaria / Q000188:drug therapy / Q000453:epidemiology*; D016017:Odds Ratio; D011159:Population Surveillance; D012307:Risk Factors; D014504:Urban Health; D014505:Urban Population
chemical_list: D000962:Antimalarials