title: A comparative case control study of the determinants of clinical malaria in The Gambia.
abstract: BACKGROUND
  The massive deployment of life saving malaria interventions has not only resulted in a decline in disease burden but a change in the risk of infection and disease. The study reassesses the importance of known risk factors and reviews demographic and socio-economic determinants of malaria risk in the population.
  
  
  METHODS
  This was a case-control study involving 150 children with test-confirmed malaria infection recruited from the outpatient clinics of three health facilities (cases) in the Greater Banjul area, The Gambia. One hundred and fifty controls, negative for malaria were matched on age, residence. Information was collected from respondents on the use of long lasting insecticidal nets, occupation, housing structure, knowledge of malaria and socio-demographic factors.
  
  
  RESULTS
  The mean age of study participants was 6.8 (SD 3.3) years with 147 (49%) being males. Significant determinants of malaria risk were parent's occupation: mother as trader (OR 0.18, 95% CI 0.04 - 0.73, p = 0.017), father as trader (OR 0.02, 95% CI 0.002- 0.193, p = 0.001), civil servants (OR 0.04, 95% CI 0.008- 0.257, p =0.001) or handyman (OR 0.03, 95% CI 0.005- 0.182, p < 0.001). Children sleeping in rooms with windowpanes had a 76% reduction in their odds of malaria (OR 0.24, 95%CI 0.07- 0.82, p = 0.022.
  
  
  CONCLUSIONS
  Household socio-economic status plays an important role in management of illnesses. The ability of mothers to engage in an occupation increases household resources to access healthcare and on time. The balance between the type of mother's occupation and her time available to supervise the child is an interesting emerging issue that needs further investigation.
authors.affiliation: Medical Research Council Unit, Fajara, The Gambia. jokebe@mrc.gm.
authors.forename: Joseph
authors.initials: J
authors.lastname: Okebe
authors.forename: Julia
authors.initials: J
authors.lastname: Mwesigwa
authors.forename: Eugene L
authors.initials: EL
authors.lastname: Kama
authors.forename: Serign J
authors.initials: SJ
authors.lastname: Ceesay
authors.forename: Fanta
authors.initials: F
authors.lastname: Njie
authors.forename: Simon
authors.initials: S
authors.lastname: Correa
authors.forename: Kalifa
authors.initials: K
authors.lastname: Bojang
mesh_terms: D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D005714:Gambia / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008288:Malaria / Q000453:epidemiology*; D008297:Male; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
references.citation: Malar J. 2011 May 25;10:145
references.pmid: 21612637
references.citation: Trans R Soc Trop Med Hyg. 2001 Nov-Dec;95(6):577-83
references.pmid: 11816424
references.citation: PLoS One. 2013 Jun 07;8(6):e65787
references.pmid: 23762425
references.citation: Ann Trop Med Parasitol. 2000 Dec;94(8):771-8
references.pmid: 11214095
references.citation: Ann Trop Med Parasitol. 1990 Dec;84(6):553-62
references.pmid: 2076033
references.citation: Trans R Soc Trop Med Hyg. 2000 Jan-Feb;94(1):17-21
references.pmid: 10748890
references.citation: Trans R Soc Trop Med Hyg. 1995 Mar-Apr;89(2):146-50
references.pmid: 7778137
references.citation: Lancet. 2008 Nov 1;372(9649):1545-54
references.pmid: 18984187
references.citation: Am J Trop Med Hyg. 2004 Aug;71(2 Suppl):1-15
references.pmid: 15331814
references.citation: Am J Trop Med Hyg. 2003 Feb;68(2):169-76
references.pmid: 12641407
references.citation: Am J Trop Med Hyg. 1986 Jan;35(1):3-15
references.pmid: 3511748
references.citation: Bull World Health Organ. 2009 Mar;87(3):216-24
references.pmid: 19377718
references.citation: Expert Rev Anti Infect Ther. 2013 Jun;11(6):623-39
references.pmid: 23750733
references.citation: Trans R Soc Trop Med Hyg. 2009 Jan;103(1):72-8
references.pmid: 18950826
references.citation: Trans R Soc Trop Med Hyg. 1989;83 Suppl:25-9
references.pmid: 2576161
references.citation: Trans R Soc Trop Med Hyg. 1993 Jun;87 Suppl 2:3-11
references.pmid: 8212107
references.citation: Trans R Soc Trop Med Hyg. 2010 Feb;104(2):143-7
references.pmid: 19732924
references.citation: Trans R Soc Trop Med Hyg. 2009 Dec;103(12):1211-20
references.pmid: 19144366
references.citation: Microbes Infect. 2004 May;6(6):572-8
references.pmid: 15158191