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Why is malaria associated with poverty? Findings from a cohort study in rural Uganda

Infectious Diseases of Poverty 2016年第1期5卷 715-725页

作者： Lucy S.Tusting John Rek Emmanuel Arinaitwe Sarah G.Staedke Moses R.Kamya Jorge Cano christian bottomley Deborah Johnston Grant Dorsey Steve W.Lindsay Jo Lines Department of Disease Control London School of Hygiene&Tropical MedicineLondonUK Big Data Institute Nuffield Department of MedicineUniversity of OxfordOxfordUK Infectious Diseases Research Collaboration KampalaUganda Department of Clinical Research London School of Hygiene and Tropical MedicineLondonUK School of Medicine Makerere University College of Health SciencesKampalaUganda MRC Tropical Epidemiology Group London School of Hygiene and Tropical MedicineLondonUK Department of Economics SOASUniversity of LondonLondonUK Department of Medicine University of CaliforniaSan FranciscoUSA School of Biological and Biomedical Sciences Durham UniversityDurhamUK

Background:Malaria control and sustainable development are linked,but implementation of‘multisectoral’intervention is restricted by a limited understanding of the causal pathways between poverty and *** investigated the relationships between socioeconomic position(SEP),potential determinants of SEP,and malaria in Nagongera,rural ***:Socioeconomic information was collected for 318 children aged six months to 10 years living in 100 households,who were followed for up to 36 *** density was recorded using monthly light trap *** prevalence was measured routinely every three months and malaria incidence determined by passive case ***,we evaluated the association between success in smallholder agriculture(the primary livelihood source)and ***,we explored socioeconomic risk factors for human biting rate(HBR),parasite prevalence and incidence of clinical malaria,and spatial clustering of socioeconomic ***,we investigated the role of selected factors in mediating the association between SEP and ***:Relative agricultural success was associated with higher *** turn,high SEP was associated with lower HBR(highest versus lowest wealth index tertile:Incidence Rate Ratio 0.71,95%confidence intervals(CI)0.54–0.93,P=0.01)and lower odds of malaria infection in children(highest versus lowest wealth index tertile:adjusted Odds Ratio 0.52,95%CI 0.35–0.78,P=0.001),but SEP was not associated with clinical malaria *** analysis suggested that part of the total effect of SEP on malaria infection risk was explained by house type(24.9%,95%CI 15.8–58.6%)and food security(18.6%,95%CI 11.6–48.3%);however,the assumptions of the mediation analysis may not have been fully ***:Housing improvements and agricultural development interventions to reduce poverty merit further investigation as multisectoral interventions against *** interdisplinary research is needed to understa

关键词： Malaria Socioeconomic Poverty Development Housing Wealth index Uganda

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