Risk factors associated with high malaria incidence among communities in selected wards in Binga district, Zimbabwe: a case-control study

Background: : Malaria remains a global problem with 216 million cases reported in 2016 and 90% of these cases were recorded in African countries. In 2018 Binga district in Zimbabwe experienced epidemics which resulted in an increase in malaria incidence from 14/1000 in 2015 to 34/1000 in 2018. This occurrence reversed the progress of wards that were moving towards malaria elimination. This study, therefore, was conducted to investigate risk factors that were associated with high malaria incidence in selected wards in Binga District. Methods: : A case-control study was conducted on sixty-one systematically randomly selected malaria cases that were matched with one hundred and eighty-three controls to identify risk factors associated with malaria infection in selected wards. The sample size was determined using EPI INFO sample size calculator and matching is done using geographic location and sex of respondents. Information on previous exposure to a risk factor(s) was obtained through a researcher administered questionnaire. Multiple Logistic Regression was conducted to determine the relationship between risk factors and malaria incidence in cases and controls on STATA Version 12 SE. Results: : On comparison, cases were more likely to have been sleeping in poorly constructed shelters with one or more house openings [OR= 5.47; CI=2.39-12.51], their household located near an active/potential mosquito breeding site or water body [OR= 5.86; CI= 2.61- 13.17] and did not own a treated bed net [OR= 9.14; CI=4.08-20.45]. Early Treatment seeking behaviour had a significant protective effect [OR= 0.51; CI= 0.39-0.86] and delay to seek treatment was influenced by distance to a health facility [OR=5.91; CI=3.02-11.55] just to mention a fewAU: Please confirm that the provided email "18851726962@163.com " is the correct address for official communication, else provide an alternate e-mail address to replace the existing one. Conclusions: : Findings of this study highlight important risk factors that are influential in the transmission of malaria. There is a need for the district to invest in source reduction by use of larvicides and reduction of possible breeding sites so as to minimise breeding. There is need to also embark on awareness campaigns to educate the community members on how they could eliminate some of the risk factors that are related to attitudes and practices. These strategies if adopted could improve the community's outcomes in as far as malaria is concerned. (C) 2020 The Author(s). Published by Elsevier B.V. on behalf of African Institute of Mathematical Sciences / Next Einstein Initiative.