Identifying populations at high risk of malaria: a mixed-methods case–control study to inform targeted interventions in Senegal
Abstract Background Senegal has made significant progress in reducing the burden of malaria, but transmission remains highly heterogeneous, with specific population subgroups likely at higher risk. Consultations with the National Malaria Control Programme (NMCP) and a review of available data identi...
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BMC
2024-12-01
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| Series: | Malaria Journal |
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| Online Access: | https://doi.org/10.1186/s12936-024-05219-z |
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| author | Tidiane Thiam Demba Kande Henry Ntuku Caterina Guinovart Natalie Galles Laura Merriman Moustapha Cissé Abiboulaye Sall Ndack Diop Aichatou Barry Diouf Mama Moussa Diaw Mamadou Diop Baba Camara Niene Seck Aliou Ndour Yakou Dieye Jennifer Smith Adam Bennett |
| author_facet | Tidiane Thiam Demba Kande Henry Ntuku Caterina Guinovart Natalie Galles Laura Merriman Moustapha Cissé Abiboulaye Sall Ndack Diop Aichatou Barry Diouf Mama Moussa Diaw Mamadou Diop Baba Camara Niene Seck Aliou Ndour Yakou Dieye Jennifer Smith Adam Bennett |
| author_sort | Tidiane Thiam |
| collection | DOAJ |
| description | Abstract Background Senegal has made significant progress in reducing the burden of malaria, but transmission remains highly heterogeneous, with specific population subgroups likely at higher risk. Consultations with the National Malaria Control Programme (NMCP) and a review of available data identified nomadic pastoralists, gold miners, and Koranic school students as potential high-risk populations (HRPs). This study aimed to evaluate whether these populations are at higher risk of malaria and better characterize their exposure patterns to inform the design of targeted intervention strategies. Methods A mixed-methods study was conducted in the districts of Ranérou, Kaolack, and Saraya between November 2020 and December 2021. A formative assessment including key informant interviews (KII) and focus group discussions (FGD) was conducted with non-HRP and HRP members (nomadic pastoralists, gold miners, Koranic school students). A health facility-based case–control study was then conducted in nine health facilities across the three districts. 501 confirmed malaria cases and 1002 non-malaria controls were frequency matched by age and sex with a ratio of 1:2. A standardized questionnaire was administered to collect sociodemographic information, including occupation, use of malaria prevention measures, mosquito exposure, and travel history. Multivariable logistic regression was used to identify malaria risk factors. Results KIIs and FGDs indicated that nomadic pastoralists, gold miners and Koranic school students have high exposure to mosquito bites through outdoor sleeping, spending time outside at night and sleeping in informal structures, with important gaps in the coverage of indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs) and limited access to health services. Compared to controls, cases had higher odds of being a nomadic pastoralist (odds ratio (OR) 4.67 95% CI 1.96–11.11) or gold miner (OR 1.92 95% CI 1.20–3.07). No evidence was found of an association with being a Koranic school student (OR 1.39 95% CI 0.80–2.39). Conclusions Nomadic pastoralists and gold miners in the study areas are at higher risk of malaria. Targeted interventions are needed to cover gaps in malaria prevention coverage and access to health services. |
| format | Article |
| id | doaj-art-8fbdb93378684df88323879459dc99df |
| institution | DOAJ |
| issn | 1475-2875 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
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| series | Malaria Journal |
| spelling | doaj-art-8fbdb93378684df88323879459dc99df2025-08-20T02:40:14ZengBMCMalaria Journal1475-28752024-12-0123111210.1186/s12936-024-05219-zIdentifying populations at high risk of malaria: a mixed-methods case–control study to inform targeted interventions in SenegalTidiane Thiam0Demba Kande1Henry Ntuku2Caterina Guinovart3Natalie Galles4Laura Merriman5Moustapha Cissé6Abiboulaye Sall7Ndack Diop8Aichatou Barry Diouf9Mama Moussa Diaw10Mamadou Diop11Baba Camara12Niene Seck13Aliou Ndour14Yakou Dieye15Jennifer Smith16Adam Bennett17PATHPATHPATHPATHPATHPATHPATHPATHPATHSenegal Ministry of Health, National Malaria Control ProgrammeSenegal Ministry of Health, National Malaria Control ProgrammeSenegal Ministry of Health, National Malaria Control ProgrammeSenegal Ministry of Health, National Malaria Control ProgrammeSenegal Ministry of Health, National Malaria Control ProgrammeSenegal Ministry of Health, National Malaria Control ProgrammePATHMalaria Elimination Initiative, University of California San FranciscoPATHAbstract Background Senegal has made significant progress in reducing the burden of malaria, but transmission remains highly heterogeneous, with specific population subgroups likely at higher risk. Consultations with the National Malaria Control Programme (NMCP) and a review of available data identified nomadic pastoralists, gold miners, and Koranic school students as potential high-risk populations (HRPs). This study aimed to evaluate whether these populations are at higher risk of malaria and better characterize their exposure patterns to inform the design of targeted intervention strategies. Methods A mixed-methods study was conducted in the districts of Ranérou, Kaolack, and Saraya between November 2020 and December 2021. A formative assessment including key informant interviews (KII) and focus group discussions (FGD) was conducted with non-HRP and HRP members (nomadic pastoralists, gold miners, Koranic school students). A health facility-based case–control study was then conducted in nine health facilities across the three districts. 501 confirmed malaria cases and 1002 non-malaria controls were frequency matched by age and sex with a ratio of 1:2. A standardized questionnaire was administered to collect sociodemographic information, including occupation, use of malaria prevention measures, mosquito exposure, and travel history. Multivariable logistic regression was used to identify malaria risk factors. Results KIIs and FGDs indicated that nomadic pastoralists, gold miners and Koranic school students have high exposure to mosquito bites through outdoor sleeping, spending time outside at night and sleeping in informal structures, with important gaps in the coverage of indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs) and limited access to health services. Compared to controls, cases had higher odds of being a nomadic pastoralist (odds ratio (OR) 4.67 95% CI 1.96–11.11) or gold miner (OR 1.92 95% CI 1.20–3.07). No evidence was found of an association with being a Koranic school student (OR 1.39 95% CI 0.80–2.39). Conclusions Nomadic pastoralists and gold miners in the study areas are at higher risk of malaria. Targeted interventions are needed to cover gaps in malaria prevention coverage and access to health services.https://doi.org/10.1186/s12936-024-05219-zMalariaRisk factorsHigh risk populations |
| spellingShingle | Tidiane Thiam Demba Kande Henry Ntuku Caterina Guinovart Natalie Galles Laura Merriman Moustapha Cissé Abiboulaye Sall Ndack Diop Aichatou Barry Diouf Mama Moussa Diaw Mamadou Diop Baba Camara Niene Seck Aliou Ndour Yakou Dieye Jennifer Smith Adam Bennett Identifying populations at high risk of malaria: a mixed-methods case–control study to inform targeted interventions in Senegal Malaria Journal Malaria Risk factors High risk populations |
| title | Identifying populations at high risk of malaria: a mixed-methods case–control study to inform targeted interventions in Senegal |
| title_full | Identifying populations at high risk of malaria: a mixed-methods case–control study to inform targeted interventions in Senegal |
| title_fullStr | Identifying populations at high risk of malaria: a mixed-methods case–control study to inform targeted interventions in Senegal |
| title_full_unstemmed | Identifying populations at high risk of malaria: a mixed-methods case–control study to inform targeted interventions in Senegal |
| title_short | Identifying populations at high risk of malaria: a mixed-methods case–control study to inform targeted interventions in Senegal |
| title_sort | identifying populations at high risk of malaria a mixed methods case control study to inform targeted interventions in senegal |
| topic | Malaria Risk factors High risk populations |
| url | https://doi.org/10.1186/s12936-024-05219-z |
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