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Temporal-spatial, individual and household level factors associated with malaria incidence in Kebele 11, Nazareth, EthiopiaIngrid Peterson
The objectives of this dissertation are to: (1) describe the spatial and temporal distribution of incident malaria infections in an urban population in highland Ethiopia during a single malaria season (2) identify household, weather and larvae factors associated with malaria risk in residential compounds in an urban population in highland Ethiopia (3) identify individual and household level factors that are independently associated with malaria risk in individuals, when factors are examined simultaneously in a multi-level model framework (4) estimate the proportion of between-household variance in malaria incidence attributable to baseline explanatory factors in an urban population in highland Ethiopia and (5) identify factors that are independently associated with recent malaria infection, when factors are examined in a matched case control framework. Data from a population based cohort study was used to identify temporal-spatial clusters of incident malaria infections during a single malaria season. These data were also used to identify household, weather and larvae factors associated with malaria risk. Multilevel analysis was carried out on a sample of the cohort data to identify individual and household level factors associated with malaria risk in individuals. Data from a case control study nested within the population cohort was used to validate the role of travel as a risk factor for malaria in the study population. The results of this study suggest: (1) a single, temporally stable malaria cluster occurred over study follow-up adjacent to the major vector-breeding site (2) house distance to the major vector-breeding site accounted for a large proportion of between-household variance in malaria risk and was associated with a large increase in malaria risk over distances of one hundred meters, (3) demographic factors, household-level environmental factors and household composition factors influenced malaria risk in children and adults, (4) although rural travel at baseline was associated with a large increase in malaria risk in adults in analysis of cohort data, this finding was not confirmed in analysis of case control data. We discuss implications and directions of future research.
Health and environmental sciences; Breeding sites; Ethiopia; Household risks; Malaria; Public health; Epidemiology; 0573:Public health; 0766:Epidemiology
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