title: Urban malaria and anaemia in children: a cross-sectional survey in two cities of Ghana.
abstract: OBJECTIVE
  To describe the epidemiology of urban malaria, an emerging problem in sub-Saharan Africa.
  
  
  METHODS
  Cross-sectional surveys of communities in Accra and Kumasi, Ghana, determining risk factors for malaria infection and anaemia in children aged 6-60 months.
  
  
  RESULTS
  Malaria prevalence rates ranged from 2% to 33% between urban communities. 47.1% of children were anaemic (Hb<11.0 g/dl). Factors associated with malaria prevalence were low socio-economic status, age and anaemia. The attributable risks of anaemia and severe anaemia (Hb<8.0 g/dl) caused by malaria were 5% and 23% respectively.
  
  
  CONCLUSIONS
  Malaria in urban areas displayed a heterogeneity and complexity that differed from the rural environment, which has important implications for malaria control. Marked intra-city variation indicates the importance of targeting specific areas or districts. The most vulnerable group, the urban poor, should be prioritized when designing control measures. This would require careful assessment of the malaria risk pattern in any city to guide an integrated control program.
authors.affiliation: International Water Management Institute, Accra, Ghana.
authors.forename: Eveline
authors.initials: E
authors.lastname: Klinkenberg
authors.forename: P J
authors.initials: PJ
authors.lastname: McCall
authors.forename: Michael D
authors.initials: MD
authors.lastname: Wilson
authors.forename: Alex O
authors.initials: AO
authors.lastname: Akoto
authors.forename: Felix P
authors.initials: FP
authors.lastname: Amerasinghe
authors.forename: Imelda
authors.initials: I
authors.lastname: Bates
authors.forename: Francine H
authors.initials: FH
authors.lastname: Verhoeff
authors.forename: Guy
authors.initials: G
authors.lastname: Barnish
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Donnelly
mesh_terms: D017677:Age Distribution; D000740:Anemia / Q000453:epidemiology* / Q000209:etiology; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007223:Infant; D008288:Malaria / Q000150:complications / Q000453:epidemiology*; D008297:Male; D018512:Parasitemia / Q000453:epidemiology; D011159:Population Surveillance / Q000379:methods; D015995:Prevalence; D012923:Social Class; D012959:Socioeconomic Factors; D014195:Travel; D014504:Urban Health
chemical_list: D006454:Hemoglobins