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Is There Evidence for Dual Causation Between Malaria and Socioeconomic Status? Findings From Rural Tanzania

Malaria’s relationship with socioeconomic status at the macroeconomic level has been established. This is the first study to explore this relationship at the microeconomic (household) level and estimate the direction of association. Malaria prevalence was measured by parasitemia, and household socioeconomic status was measured using an asset based index. Results from an instrumental variable probit model suggest that socioeconomic status is negatively associated with malaria parasitemia. Other variables that are significantly associated with parasitemia include age of the individual, use of a mosquito net on the night before interview, the number of people living in the household, whether the household was residing at their farm home at the time of interview, household wall construction, and the region of residence. Matching estimators indicate that malaria parasitemia is associated with reduced household socioeconomic status.

Received August 20, 2006. Accepted for publication September 5, 2007.

Acknowledgments: We thank the Ifakara Health Research and Development Centre for their support and assistance throughout the data collection process. The field work would not have been possible without the help of Rashid Khatib, Jensen Charles, Chrisostom Mahutanga, and Berty F. Elling. The IMPACT Tanzania project was also supportive during data collection and shared information with this project.

Financial support: This work forms part of Masha Somi’s PhD project, and has been funded through an Australian Government scholarship and the Australian National University.

Disclaimer: The findings and conclusions presented in this paper are those of the authors and do not necessarily represent those of the United States Public Health Service or the Centers for Disease Control and Prevention (CDC). The Interdisciplinary Monitoring Project for Antimalarial Combination Therapy in Tanzania (IMPACT-Tz) is a multiyear implementation research evaluation project that rests on a collaborative platform comprising the CDC, Ifakara Health Research and Development Centre, the National Institute for Medical Research, London School of Hygiene and Tropical Medicine (UK), and the Tanzanian Ministry of Health, including its National Malaria Control Programme, the Tanzania Essential Health Interventions Project, and the Council Health Management Teams of Rufiji, Morogoro, Mvomeru, Kilombero and Ulanga Districts. IMPACT-Tz is primarily supported by funding from CDC, the United States Agency for International Development and Wellcome Trust.

^* Address correspondence to Masha F. Somi, Cnr Mills and Eggleston Roads, Canberra 0200, Australia. E-mail: masha.somi{at}anu.edu.au

Authors’ addresses: Masha F. Somi, Australian Centre for Economic Research on Health, Australian National University, Canberra ACT 0200, Australia, Telephone: 61–2–61253688, E-mail: masha.somi{at}anu.edu.au. James R. G. Butler, Australian Centre for Economic Research on Health, Australian National University, Canberra ACT 0200, Australia, Telephone: 61–2–61253688, E-mail: jim.butler{at}anu.edu.au. Farhid Vahid, School of Economics, Australian National University, Canberra ACT 0200, Australia, Telephone: 61–2–61258164, E-mail: farshid.vahid{at}anu.edu.au. Joseph Njau, Ifakara Health Research and Development Centre, PO Box 78373, Dar es Salaam, Tanzania. Telephone: 255–222–774714, E-mail: jnjau{at}ihrdc.or.tz or joseph.don{at}gmail.com. S. Patrick Kachur, CDC/IHRDC Malaria Program in Tanzania, Ifakara Health Research and Development Centre, PO Box 78373, Dar es Salaam, Tanzania. Telephone: 255–222–774714, E-mail: skachur{at}cdc.gov. Salim Abdulla, Ifakara Health Research and Development Centre, PO Box 78373, Dar es Salaam, Tanzania, Telephone: 255–222–774714, E-mail: sabdulla{at}ihrdc.or.tz or salim_abdulla{at}hotmail.com.

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