title: Individual, household and environmental risk factors for malaria infection in Amhara, Oromia and SNNP regions of Ethiopia.
abstract: We assessed malaria infection in relation to age, altitude, rainfall, socio-economic factors and coverage of control measures in a representative sample of 11437 people in Amhara, Oromia and SNNP regions of Ethiopia in December 2006-January 2007. Surveys were conducted in 224 randomly selected clusters of 25 households (overall sample of 27884 people in 5708 households). In 11538 blood slides examined from alternate households (83% of those eligible), malaria prevalence in people of all ages was 4.1% (95% CI 3.4-4.9), with 56.5% of infections being Plasmodium falciparum. At least one mosquito net or one long-lasting insecticidal net (LLIN) was present in 37.0% (95% CI 31.1-43.3) and 19.6% (95% CI 15.5-24.5) of households, respectively. In multivariate analysis (n=11437; 82% of those eligible), significant protective factors were: number of LLINs per household (odds ratio [OR] (per additional net)=0.60; 95% CI 0.40-0.89), living at higher altitude (OR (per 100 m)=0.95; 95% CI 0.90-1.00) and household wealth (OR (per unit increase in asset index)=0.79; 95% CI 0.66-0.94). Malaria prevalence was positively associated with peak monthly rainfall in the year before the survey (OR (per additional 10 mm rain)=1.10; 95% CI 1.03-1.18). People living above 2000 m and people of all ages are still at significant risk of malaria infection.
authors.affiliation: The Carter Center, 1 Copenhill, Atlanta, GA 30307, USA. cex4@cdc.gov
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Graves
authors.forename: Frank O
authors.initials: FO
authors.lastname: Richards
authors.forename: Jeremiah
authors.initials: J
authors.lastname: Ngondi
authors.forename: Paul M
authors.initials: PM
authors.lastname: Emerson
authors.forename: Estifanos Biru
authors.initials: EB
authors.lastname: Shargie
authors.forename: Tekola
authors.initials: T
authors.lastname: Endeshaw
authors.forename: Pietro
authors.initials: P
authors.lastname: Ceccato
authors.forename: Yeshewamebrat
authors.initials: Y
authors.lastname: Ejigsemahu
authors.forename: Aryc W
authors.initials: AW
authors.lastname: Mosher
authors.forename: Afework
authors.initials: A
authors.lastname: Hailemariam
authors.forename: Mulat
authors.initials: M
authors.lastname: Zerihun
authors.forename: Tesfaye
authors.initials: T
authors.lastname: Teferi
authors.forename: Berhan
authors.initials: B
authors.lastname: Ayele
authors.forename: Ayenew
authors.initials: A
authors.lastname: Mesele
authors.forename: Gideon
authors.initials: G
authors.lastname: Yohannes
authors.forename: Abate
authors.initials: A
authors.lastname: Tilahun
authors.forename: Teshome
authors.initials: T
authors.lastname: Gebre
mesh_terms: D000293:Adolescent; D000328:Adult; D000531:Altitude; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D005002:Ethiopia / Q000453:epidemiology; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008288:Malaria / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission*; D008297:Male; D008875:Middle Aged; D009032:Mosquito Control; D057147:Mosquito Nets / Q000706:statistics & numerical data*; D016017:Odds Ratio; D011247:Pregnancy; D015995:Prevalence; D011891:Rain; D012307:Risk Factors; D012959:Socioeconomic Factors; D055815:Young Adult