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Human Ecology of Malaria in a Rural Highland Region of South-West Kenya

dc.contributor.advisorKistemann, Thomas
dc.contributor.authorGithinji, Sophia Wanjiku
dc.date.accessioned2020-04-14T05:05:03Z
dc.date.available2020-04-14T05:05:03Z
dc.date.issued22.12.2009
dc.identifier.urihttp://hdl.handle.net/20.500.11811/4174
dc.description.abstractMalaria kills nearly a million people a year, uses almost half of the clinical services in Africa, and reduces economic growth by up to 1%. The immense and persistent burden of malaria makes its control one of the most important challenges in global public health. The present study examined the associations of malaria incidences with micro-ecological, socio-demographic and behavioural aspects in a rural epidemic zone in south-west Kenya.
A case-control epidemiological study design was applied. Malaria patients seeking treatment at a rural health care facility were randomly sampled during a peak transmission period between May and July 2007. Each case was individually matched with a control of the same sex and approximately the same age, drawn from patients suffering from diseases of the respiratory system. In total, 342 cases and 328 controls were sampled. A standardised questionnaire investigating the social, demographic and behavioural aspects related to malaria at the household level was administered. A spot check of factors which could favour mosquito breeding and their contact with human beings was done in and around the survey homesteads. The homesteads were geo-positioned with a hand held global positioning system and straight line distances from the study households to possible risk areas measured. Statistical analyses were done with conditional logistic regression using STATA. Spatial analysis was done with SaTscanTM and ArcGIS.
Location of houses on flat swampy areas (mOR 1.81, p-value 0.03), staying outdoors at night (mOR 1.94, p-value 0.03); presence of oxen in the compound (mOR 1.53, p-value 0.03); sleeping in houses with open eaves (mOR 1.45, p-value 0.03) and family size greater than four people (mOR 1.44, p-value 0.04) were associated with increased risk of malaria while sufficient food supplies (mOR 0.60, p-value 0.003) and keeping medicine at home (mOR 0.58, p-value 0.006) were associated with reduced risk of the disease. These findings point to the need for holistic approaches that draw connections between behavioural, socio-economic and micro-ecological factors in malaria control.
dc.language.isoeng
dc.rightsIn Copyright
dc.rights.urihttp://rightsstatements.org/vocab/InC/1.0/
dc.subjectMalaria
dc.subjectEinflussfaktoren
dc.subjectmikro-ökologisches Risiko
dc.subjectsozioökonomisch Faktoren
dc.subjectKenia
dc.subjectinfluencing factors
dc.subjectmicroecological risk
dc.subjectsocio-economic factors
dc.subject.ddc610 Medizin, Gesundheit
dc.subject.ddc630 Landwirtschaft, Veterinärmedizin
dc.titleHuman Ecology of Malaria in a Rural Highland Region of South-West Kenya
dc.typeDissertation oder Habilitation
dc.publisher.nameUniversitäts- und Landesbibliothek Bonn
dc.publisher.locationBonn
dc.rights.accessRightsopenAccess
dc.identifier.urnhttps://nbn-resolving.org/urn:nbn:de:hbz:5N-19749
ulbbn.pubtypeErstveröffentlichung
ulbbnediss.affiliation.nameRheinische Friedrich-Wilhelms-Universität Bonn
ulbbnediss.affiliation.locationBonn
ulbbnediss.thesis.levelDissertation
ulbbnediss.dissID1974
ulbbnediss.date.accepted30.11.2009
ulbbnediss.fakultaetMathematisch-Naturwissenschaftliche Fakultät
dc.contributor.coRefereeVlek, Paul L. G.


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