Relating household entomological measures to individual malaria risk
Abstract Background The gold standard measure of malaria exposure is the entomological inoculation rate (EIR), or the number of infectious bites an individual receives over a given period. Nevertheless, it is unclear whether EIR measured in the households of individuals reflects heterogeneity in tho...
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| Format: | Article |
| Language: | English |
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BMC
2025-08-01
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| Series: | Malaria Journal |
| Online Access: | https://doi.org/10.1186/s12936-025-05504-5 |
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| author | Max McClure Emmanuel Arinaitwe Moses R. Kamya Philip J. Rosenthal Joaniter Nankabirwa Maxwell Kilama Alex Musiime Grant Dorsey Bryan Greenhouse Isabel Rodriguez-Barraquer |
| author_facet | Max McClure Emmanuel Arinaitwe Moses R. Kamya Philip J. Rosenthal Joaniter Nankabirwa Maxwell Kilama Alex Musiime Grant Dorsey Bryan Greenhouse Isabel Rodriguez-Barraquer |
| author_sort | Max McClure |
| collection | DOAJ |
| description | Abstract Background The gold standard measure of malaria exposure is the entomological inoculation rate (EIR), or the number of infectious bites an individual receives over a given period. Nevertheless, it is unclear whether EIR measured in the households of individuals reflects heterogeneity in those individuals’ infection risk. Methods To investigate this relationship, this study used data collected from a cohort of 439 children aged 0.5–5 years in 239 households from 2011–2016 in three Ugandan districts: low-EIR Jinja, intermediate-EIR Kanungu and high-EIR Tororo. Participants underwent passive and quarterly active surveillance for clinical malaria, defined as fever with positive thick blood smear. Monthly vector densities and sporozoite rates in participating households were estimated using CDC light traps. The association between spatiotemporally smoothed household log2-transformed EIR and individual malaria incidence was assessed using Poisson generalized additive mixed effects models. Results Comparison across sites suggested an increasing relationship between average EIR and malaria incidence. Within-site relationships, however, varied by site, with a positive association in Kanungu (incidence rate ratio [IRR] 1.09, 95% credible interval 1.04–1.14) but none in Jinja (1.02, 0.774–1.26) or Tororo (1.02, 0.986–1.06). Conclusions These results show the relationship between measured EIR and malaria incidence may depend on site-specific transmission dynamics and be strongest at intermediate EIR, while underscoring the challenges of using household-level measures of exposure. |
| format | Article |
| id | doaj-art-2ed4f6638ec34bd095b892ccc642df7d |
| institution | Kabale University |
| issn | 1475-2875 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Malaria Journal |
| spelling | doaj-art-2ed4f6638ec34bd095b892ccc642df7d2025-08-20T03:45:47ZengBMCMalaria Journal1475-28752025-08-0124111110.1186/s12936-025-05504-5Relating household entomological measures to individual malaria riskMax McClure0Emmanuel Arinaitwe1Moses R. Kamya2Philip J. Rosenthal3Joaniter Nankabirwa4Maxwell Kilama5Alex Musiime6Grant Dorsey7Bryan Greenhouse8Isabel Rodriguez-Barraquer9Department of Medicine, San Francisco General Hospital, University of California, San FranciscoInfectious Diseases Research CollaborationInfectious Diseases Research CollaborationDepartment of Medicine, San Francisco General Hospital, University of California, San FranciscoInfectious Diseases Research CollaborationInfectious Diseases Research CollaborationNational Malaria Control Division, Ministry of HealthDepartment of Medicine, San Francisco General Hospital, University of California, San FranciscoDepartment of Medicine, San Francisco General Hospital, University of California, San FranciscoDepartment of Medicine, San Francisco General Hospital, University of California, San FranciscoAbstract Background The gold standard measure of malaria exposure is the entomological inoculation rate (EIR), or the number of infectious bites an individual receives over a given period. Nevertheless, it is unclear whether EIR measured in the households of individuals reflects heterogeneity in those individuals’ infection risk. Methods To investigate this relationship, this study used data collected from a cohort of 439 children aged 0.5–5 years in 239 households from 2011–2016 in three Ugandan districts: low-EIR Jinja, intermediate-EIR Kanungu and high-EIR Tororo. Participants underwent passive and quarterly active surveillance for clinical malaria, defined as fever with positive thick blood smear. Monthly vector densities and sporozoite rates in participating households were estimated using CDC light traps. The association between spatiotemporally smoothed household log2-transformed EIR and individual malaria incidence was assessed using Poisson generalized additive mixed effects models. Results Comparison across sites suggested an increasing relationship between average EIR and malaria incidence. Within-site relationships, however, varied by site, with a positive association in Kanungu (incidence rate ratio [IRR] 1.09, 95% credible interval 1.04–1.14) but none in Jinja (1.02, 0.774–1.26) or Tororo (1.02, 0.986–1.06). Conclusions These results show the relationship between measured EIR and malaria incidence may depend on site-specific transmission dynamics and be strongest at intermediate EIR, while underscoring the challenges of using household-level measures of exposure.https://doi.org/10.1186/s12936-025-05504-5 |
| spellingShingle | Max McClure Emmanuel Arinaitwe Moses R. Kamya Philip J. Rosenthal Joaniter Nankabirwa Maxwell Kilama Alex Musiime Grant Dorsey Bryan Greenhouse Isabel Rodriguez-Barraquer Relating household entomological measures to individual malaria risk Malaria Journal |
| title | Relating household entomological measures to individual malaria risk |
| title_full | Relating household entomological measures to individual malaria risk |
| title_fullStr | Relating household entomological measures to individual malaria risk |
| title_full_unstemmed | Relating household entomological measures to individual malaria risk |
| title_short | Relating household entomological measures to individual malaria risk |
| title_sort | relating household entomological measures to individual malaria risk |
| url | https://doi.org/10.1186/s12936-025-05504-5 |
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