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Expanding agricultural irrigation efforts to enhance food security and socioeconomic development in sub-Saharan Africa may affect malaria transmission and socioeconomic variables that increase the risk of anemia in local communities. We compared the prevalence of anemia, Plasmodium falciparum infection, and indicators of socioeconomic status related to nutrition in communities in Homa Bay County, Kenya, where an agricultural irrigation scheme has been implemented, to that in nearby communities where there is no agricultural irrigation. Cross-sectional surveys conducted showed that anemia prevalence defined by WHO criteria (hemoglobin < 11 g/dL) was less in communities in the irrigated areas than in the non-irrigated areas during the wet season (38.9% and 51.5%, χ2 = 4.29, P = 0.001) and the dry season (25.2% and 34.1%, χ2 = 7.33, P = 0.007). In contrast, Plasmodium falciparum infection prevalence was greater during the wet season in irrigated areas than in non-irrigated areas (15.3% versus 7.8%, χ2 = 8.7, P = 0.003). There was, however, no difference during the dry season (infection prevalence, < 1.8%). Indicators of nutritional status pertinent to anemia pathogenesis such as weekly consumption of non–heme- and heme-containing foods and household income were greater in communities located within the irrigation scheme versus those outside the irrigation scheme (P < 0.0001). These data indicate that current agricultural irrigation schemes in malaria-endemic communities in this area have reduced the risk of anemia. Future studies should include diagnostic tests of iron deficiency, parasitic worm infections, and genetic hemoglobin disorders to inform public health interventions aimed at reducing community anemia burden.
Financial support: This study was financed by grants from the NIH (U19 AI129326, D43 TW001505, and R01 AI050243).
Authors’ addresses: Collince J. Omondi, David Odongo, and Antony Otieno, Department of Biology, Faculty of Science and Technology, University of Nairobi, Kenya, E-mails: email@example.com, firstname.lastname@example.org, and email@example.com. Kevin O. Ochwedo, Shirley A. Onyango, Pauline Orondo, and Benyl M. Ondeto, International Center of Excellence in Malaria Research, Tom Mboya University College, Homa Bay, Kenya, E-mails: firstname.lastname@example.org, email@example.com, firstname.lastname@example.org, and email@example.com. Henry Athiany, School of Mathematics and Physical Sciences, Jomo Kenyatta University of Agriculture and Technology, Kenya, E-mail: firstname.lastname@example.org. Ming-Chieh Lee, Program in Public Health, University of California, Irvine, CA, E-mail: email@example.com. James W. Kazura, Center for Global Health and Diseases, Case Western Reserve University, Cleveland, OH, E-mail: firstname.lastname@example.org. Andrew K. Githeko, International Center of Excellence in Malaria Research, Tom Mboya University College, Homa Bay, Kenya, and Climate and Human Health Research Unit, Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya. Guiyun Yan, Program in Public Health, University of California, Irvine, CA, E-mail: email@example.com.