Spatial variation of malaria incidence in young children from a geographically homogeneous area with high endemicity

J Infect Dis. 2008 Jan 1;197(1):85-93. doi: 10.1086/524066.


Background: In sub-Saharan Africa, malaria is a leading cause of morbidity and mortality among young children. Detailed knowledge of spatial variation of malaria epidemiology and associated risk factors is important for planning and evaluating malaria-control measures.

Methods: The spatial variation of malaria incidences and socioeconomic factors were assessed over 21 months, from January 2003 to September 2005, in 535 children from 9 villages of a small rural area with high Plasmodium falciparum transmission in Ghana. Household positions were mapped by use of a global positioning system, and the spatial effects on malaria rates were assessed by means of ecological analyses and bivariate Poisson regression controlling for possible confounding factors.

Results: Malaria incidence was surprisingly heterogeneous between villages, and ecological analyses showed strong correlations with village area (R(2) = 0.74; P = .003) and population size (R(2) = 0.68; P = .006). Malaria risk was affected by a number of socioeconomic factors. Poisson regression showed an independent linear rate reduction with increasing distance between children's households and the fringe of the forest.

Conclusions: The exact location of households in villages is an independent and important factor for the variation of malaria incidence in children from high-transmission areas. This fact should be considered in the planning of intervention trials and in spatial targeting of malaria interventions at a local level.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Endemic Diseases
  • Female
  • Geographic Information Systems
  • Ghana / epidemiology
  • Humans
  • Incidence
  • Infant
  • Malaria, Falciparum / epidemiology*
  • Male
  • Prospective Studies
  • Rural Population
  • Topography, Medical*
  • Trees / parasitology*