Emergence of urban malaria and the associated risk factors: a case–control study in Mutare city, Zimbabwe
Abstract Background Mutare city of Zimbabwe was considered free of autochthonous malaria, until 2017, when the Ministry of Health and Child Care formally confirmed escalating cases of locally transmitted malaria in the city. The current study examined the risk factors for malaria cases in the city t...
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2025-07-01
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| Series: | Malaria Journal |
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| Online Access: | https://doi.org/10.1186/s12936-025-05494-4 |
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| author | Sungano Mharakurwa Natasha Mbwana Trish Mharakurwa Thelma Karumbidza Vuyisile Mathe Punha Fusire Andrew Tangwena Wilson Chauke Munyaradzi Mukuzunga Patience Dhliwayo Shungu Mtero Munyati Lovemore Gwanzura Jeffrey A. Bailey William J. Moss |
| author_facet | Sungano Mharakurwa Natasha Mbwana Trish Mharakurwa Thelma Karumbidza Vuyisile Mathe Punha Fusire Andrew Tangwena Wilson Chauke Munyaradzi Mukuzunga Patience Dhliwayo Shungu Mtero Munyati Lovemore Gwanzura Jeffrey A. Bailey William J. Moss |
| author_sort | Sungano Mharakurwa |
| collection | DOAJ |
| description | Abstract Background Mutare city of Zimbabwe was considered free of autochthonous malaria, until 2017, when the Ministry of Health and Child Care formally confirmed escalating cases of locally transmitted malaria in the city. The current study examined the risk factors for malaria cases in the city to aid in formulation of targeted intervention packages for helping restore malaria-free status. Methods The study employed complementary cross-sectional and case–control designs to ascertain the magnitude and risk factors of urban malaria cases presenting at all eight primary health care facilities of Mutare city from 2022 to 2023. Malaria cases were enrolled as confirmed by RDT or microscopy on presenting all-age symptomatic suspected malaria patients. Controls were similarly enrolled as all-age symptomatic suspected malaria patients found negative by both RDT and microscopy. All cases and controls were enrolled as representative of the presenting population with no matching. Data were analysed for descriptive and prevalence statistics, as well as risk factors, using SPSS Faculty version 27. Results In a multivariate binary logistic model, significant risk factors for malaria cases found in the city included residential locale (RR [95%CI]: 3 [1.1–5.8], p = 0.029, N = 7,222), household proximity to still surface water pools or unprotected wells (16 [3.8–67.5], p < 0.001) and travel history in the past 2 weeks (9 [5.2–14.4], p < 0.001, N = 7,222), modal travel destinations being malaria-endemic adjoining districts within Zimbabwe, as well as areas of neighbouring Mozambique, mainly for trade or work. By far the most predominant risk factor for malaria cases was artisanal mining (RR [95%CI]: 22 [10.7–44.1], p < 0.001), which was 93% dominated by men, and male residents exhibited four-fold higher odds of being malaria cases than females (4 [2.0–6.5]). Conclusions Significant risk factors for urban malaria were found that were consistent with both autochthonous transmission and imported malaria in Mutare city. Environmental management and the deployment and concomitant promotion of mass ITNs, personal protection and other intervention packages, especially targeting communities exposed to the identified risk factors, would be instrumental towards re-establishing urban malaria elimination from Mutare city. |
| format | Article |
| id | doaj-art-2fbe8614b0d841d096d7f776657dff48 |
| institution | Kabale University |
| issn | 1475-2875 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
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| series | Malaria Journal |
| spelling | doaj-art-2fbe8614b0d841d096d7f776657dff482025-08-20T04:01:47ZengBMCMalaria Journal1475-28752025-07-012411810.1186/s12936-025-05494-4Emergence of urban malaria and the associated risk factors: a case–control study in Mutare city, ZimbabweSungano Mharakurwa0Natasha Mbwana1Trish Mharakurwa2Thelma Karumbidza3Vuyisile Mathe4Punha Fusire5Andrew Tangwena6Wilson Chauke7Munyaradzi Mukuzunga8Patience Dhliwayo9Shungu Mtero Munyati10Lovemore Gwanzura11Jeffrey A. Bailey12William J. Moss13Africa University, Old MutareAfrica University, Old MutareAfrica University, Old MutareAfrica University, Old MutareAfrica University, Old MutareManicaland Provincial Medical Directorate, Ministry of Health and Child CareNational Malaria Control Programme, Ministry of Health and Child CareNational Malaria Control Programme, Ministry of Health and Child CareManicaland Provincial Medical Directorate, Ministry of Health and Child CareNational Malaria Control Programme, Ministry of Health and Child CareBiomedical Research and Training InstituteBiomedical Research and Training InstituteBrown UniversityJohns Hopkins Bloomberg School of Public HealthAbstract Background Mutare city of Zimbabwe was considered free of autochthonous malaria, until 2017, when the Ministry of Health and Child Care formally confirmed escalating cases of locally transmitted malaria in the city. The current study examined the risk factors for malaria cases in the city to aid in formulation of targeted intervention packages for helping restore malaria-free status. Methods The study employed complementary cross-sectional and case–control designs to ascertain the magnitude and risk factors of urban malaria cases presenting at all eight primary health care facilities of Mutare city from 2022 to 2023. Malaria cases were enrolled as confirmed by RDT or microscopy on presenting all-age symptomatic suspected malaria patients. Controls were similarly enrolled as all-age symptomatic suspected malaria patients found negative by both RDT and microscopy. All cases and controls were enrolled as representative of the presenting population with no matching. Data were analysed for descriptive and prevalence statistics, as well as risk factors, using SPSS Faculty version 27. Results In a multivariate binary logistic model, significant risk factors for malaria cases found in the city included residential locale (RR [95%CI]: 3 [1.1–5.8], p = 0.029, N = 7,222), household proximity to still surface water pools or unprotected wells (16 [3.8–67.5], p < 0.001) and travel history in the past 2 weeks (9 [5.2–14.4], p < 0.001, N = 7,222), modal travel destinations being malaria-endemic adjoining districts within Zimbabwe, as well as areas of neighbouring Mozambique, mainly for trade or work. By far the most predominant risk factor for malaria cases was artisanal mining (RR [95%CI]: 22 [10.7–44.1], p < 0.001), which was 93% dominated by men, and male residents exhibited four-fold higher odds of being malaria cases than females (4 [2.0–6.5]). Conclusions Significant risk factors for urban malaria were found that were consistent with both autochthonous transmission and imported malaria in Mutare city. Environmental management and the deployment and concomitant promotion of mass ITNs, personal protection and other intervention packages, especially targeting communities exposed to the identified risk factors, would be instrumental towards re-establishing urban malaria elimination from Mutare city.https://doi.org/10.1186/s12936-025-05494-4PlasmodiumUrban malariaEmergenceRisk factorTransmissionElimination |
| spellingShingle | Sungano Mharakurwa Natasha Mbwana Trish Mharakurwa Thelma Karumbidza Vuyisile Mathe Punha Fusire Andrew Tangwena Wilson Chauke Munyaradzi Mukuzunga Patience Dhliwayo Shungu Mtero Munyati Lovemore Gwanzura Jeffrey A. Bailey William J. Moss Emergence of urban malaria and the associated risk factors: a case–control study in Mutare city, Zimbabwe Malaria Journal Plasmodium Urban malaria Emergence Risk factor Transmission Elimination |
| title | Emergence of urban malaria and the associated risk factors: a case–control study in Mutare city, Zimbabwe |
| title_full | Emergence of urban malaria and the associated risk factors: a case–control study in Mutare city, Zimbabwe |
| title_fullStr | Emergence of urban malaria and the associated risk factors: a case–control study in Mutare city, Zimbabwe |
| title_full_unstemmed | Emergence of urban malaria and the associated risk factors: a case–control study in Mutare city, Zimbabwe |
| title_short | Emergence of urban malaria and the associated risk factors: a case–control study in Mutare city, Zimbabwe |
| title_sort | emergence of urban malaria and the associated risk factors a case control study in mutare city zimbabwe |
| topic | Plasmodium Urban malaria Emergence Risk factor Transmission Elimination |
| url | https://doi.org/10.1186/s12936-025-05494-4 |
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