title: Malaria prevalence in Bata district, Equatorial Guinea: a cross-sectional study.
abstract: BACKGROUND
  Malaria has traditionally been a leading public health problem in Equatorial Guinea. After completion, in September 2011, of the integrated set of interventions against malaria launched by the Global Fund Malaria Programme in the mainland area, the epidemiological situation of malaria remains unknown. The aim of this study was to investigate the prevalence rate of malaria and associated factors based on the rapid diagnosis test (RDT) in Bata district, in order to provide evidence that will reinforce the National Malaria Control Programme.
  
  
  METHODS
  From June to August 2013, a representative cross sectional survey using a multistage, stratified, cluster-selected sample was carried out in urban zones and rural villages from Bata district. Data on socio-demographic, health status and malaria-related behaviours was collected. Malaria diagnosis was performed by RDT. Bivariate and multivariable statistical methods were employed to assess malaria prevalence and its association with different factors.
  
  
  RESULTS
  Prevalence of malaria was higher in rural settings (58.9 %; CI 95 % 55.2-62.5 %) than in the sampled urban communities (33.9 %; CI 95 % 31.1-36.9 %). Presence of anaemia was also high, especially in rural sites (89.6 vs. 82.8 %, p < 0.001). The analyses show that a positive RDT result was significantly associated with age group, the most affected age range being 13 months-14 years old. Other significant covariates were ethnic group (only in urban sites), number of adults living in the house (only in rural villages) previous history of fever, anaemia (only in urban sites) and sleeping under a bed net. Moreover, those who never slept under a bed net were two times more likely to have malaria.
  
  
  CONCLUSIONS
  The prevalence of malaria was high in Bata district, especially in rural villages. The National Programme to fight malaria in Equatorial Guinea should take into account the differences found between rural and urban communities and age groups to target appropriately those worst affected. The findings of this study will assist in planning and undertaking regional policy and other preventive initiatives.
authors.affiliation: Reference Centre for Epidemics Control of Equatorial Guinea (CRCE), Ministry of Health and Social Welfare, Malabo, Equatorial Guinea. pncogo@crce-guinea.org.
authors.forename: Policarpo
authors.initials: P
authors.lastname: Ncogo
authors.affiliation: National Centre of Tropical Medicine, Instituto de Salud Carlos III (ISCIII) C/Sinesio Delgado, 6-Pabellón 13, 28029, Madrid, Spain. zherrador@isciii.es.|The Spanish Tropical Diseases Research Network (RICET in Spanish), Madrid, Spain. zherrador@isciii.es.
authors.forename: Zaida
authors.initials: Z
authors.lastname: Herrador
authors.affiliation: National Centre of Tropical Medicine, Instituto de Salud Carlos III (ISCIII) C/Sinesio Delgado, 6-Pabellón 13, 28029, Madrid, Spain. mromay@isciii.es.|The Spanish Tropical Diseases Research Network (RICET in Spanish), Madrid, Spain. mromay@isciii.es.
authors.forename: Maria
authors.initials: M
authors.lastname: Romay-Barja
authors.affiliation: Department of Preventive Medicine, University Hospital of Albacete, Albacete, Spain. mlycarrasco@gmail.com.
authors.forename: Emely
authors.initials: E
authors.lastname: García-Carrasco
authors.affiliation: Ministry of Health and Social Welfare, Malabo, Equatorial Guinea. glorianseng@yahoo.es.
authors.forename: Gloria
authors.initials: G
authors.lastname: Nseng
authors.affiliation: National Centre of Tropical Medicine, Instituto de Salud Carlos III (ISCIII) C/Sinesio Delgado, 6-Pabellón 13, 28029, Madrid, Spain. pberzosa@isciii.es.
authors.forename: Pedro
authors.initials: P
authors.lastname: Berzosa
authors.affiliation: The Spanish Tropical Diseases Research Network (RICET in Spanish), Madrid, Spain. msanmor@msn.com.|Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias, Universidad de la Laguna, La Laguna, Canary Islands, Spain. msanmor@msn.com.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Santana-Morales
authors.affiliation: Ministry of Health and Social Welfare, Malabo, Equatorial Guinea. riloharivas@yahoo.es.
authors.forename: Matilde
authors.initials: M
authors.lastname: Riloha
authors.affiliation: National Centre of Tropical Medicine, Instituto de Salud Carlos III (ISCIII) C/Sinesio Delgado, 6-Pabellón 13, 28029, Madrid, Spain. paparicio@isciii.es.|The Spanish Tropical Diseases Research Network (RICET in Spanish), Madrid, Spain. paparicio@isciii.es.
authors.forename: Pilar
authors.initials: P
authors.lastname: Aparicio
authors.affiliation: The Spanish Tropical Diseases Research Network (RICET in Spanish), Madrid, Spain. bvallada@ull.es.|Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias, Universidad de la Laguna, La Laguna, Canary Islands, Spain. bvallada@ull.es.
authors.forename: Basilio
authors.initials: B
authors.lastname: Valladares
authors.affiliation: National Centre of Tropical Medicine, Instituto de Salud Carlos III (ISCIII) C/Sinesio Delgado, 6-Pabellón 13, 28029, Madrid, Spain. abenito@isciii.es.|The Spanish Tropical Diseases Research Network (RICET in Spanish), Madrid, Spain. abenito@isciii.es.
authors.forename: Agustín
authors.initials: A
authors.lastname: Benito
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D016703:Equatorial Guinea / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D008288:Malaria / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012424:Rural Population; D014505:Urban Population; D055815:Young Adult