Socio-economic status as predictors of malaria transmission in KwaZulu-Natal, South Africa. A retrospective study

Abstract

Background: Understanding the socioeconomic status that influences malaria transmission in KwaZulu-Natal, South Africa is vital in creating policies and strategies to combat malaria transmission, improve socioeconomic conditions and strengthen the malaria elimination campaign. Objectives: To determine the relationship between socioeconomic status and malaria incidence in KwaZulu-Natal, South Africa. Methods: Socioeconomic information (gender, age, no formal education, no electricity, no toilet facilities, unemployment) and malaria data for 2011 were obtained from Statistics South Africa and the malaria control program of KwaZulu-Natal, South Africa respectively. The analysis was conducted employing the Bayesian multiple regression model. Results: The obtained posterior samples show that all the variables employed in this study were significant and positive predictors of malaria disease at 95% credible interval. The low socioeconomic status that exhibited the strongest association with malaria risk was lack of toilet facilities (odd ratio =12.39; 95% credible interval = 0.61, 24.36). This was followed by no formal education (odd ratio =11.11; 95% credible interval = 0.51, 24.10) and lack of electricity supply (odd ratio =8.94; 95% credible interval = 0.31, 23.21) respectively. Conclusions: Low socioeconomic status potentially sustains malaria transmission and burden. As an implication, poverty alleviation and malaria intervention resources should be incorporated side by side into the socioeconomic framework to attain zero malaria transmission. Keywords: Malaria; socialeconomic status; Bayesian modelling; KwaZulu-Natal; South Africa.