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Occupational Activities Associated with a Reported History of Malaria among Women Working in Small-Scale Agriculture in South Africa

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  • Department of Occupational and Environmental Health, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Congella, Durban, South Africa; Centre for Occupational and Environmental Health, Department of Public Health, University of Cape Town, Cape Town, South Africa; Department of Public Health, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands; Institute for Risk Assessment Sciences, Environmental Epidemiology Division, Utrecht University, Utrecht, The Netherlands
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Malaria-endemic agricultural communities are at risk for this disease because of crop and agricultural activities. A cross-sectional survey among women in small-scale agriculture on irrigated and dryland areas in Makhatini Flats, KwaZulu-Natal South Africa explored associations with self-reported history of malaria, including demographics, crop production, and specific agricultural activities. Ninety-eight (15.2%) of 644 women reported malaria while working in agriculture. More women working in drylands than women working in irrigation scheme reported disease (18.4% versus 10.9%; P < 0.05). Working self or family-owned farms (prevalence ratio [PR] = 2.6, 95% confidence interval [CI] = 1.3–5.2), spraying pesticides (PR = 2.3; 95% CI = 1.4–3.8), cultivating sugar cane (PR = 1.6, 95% CI = 1.1–2.3), and cultivating cotton and mangoes (PR = 1.7, 95% CI = 1.1–2.6) were positively associated with a history of malaria while working in agriculture. This study suggests that certain agricultural activities and types of crop production may increase the risk for malaria among women working in small-scale agriculture.

Author Notes

*Address correspondence to Saloshni Naidoo, Department of Occupational and Environmental Health, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Private Bag 7, Congella, Durban 4013, South Africa. E-mail: naidoos71@ukzn.ac.za

Financial support: This study was supported by the South African Netherlands Research Programme on Alternatives in Development and the South African Medical Research Council.

Disclosure: None of the authors have any direct interests in the funding organizations and to the best of our knowledge the study is unlikely to benefit any organization financially.

Authors' addresses: Saloshni Naidoo and Rajen N. Naidoo, Department of Occupational and Environmental Health, School of Family and Public Health Medicine, Nelson R. Mandela, School of Medicine, University of KwaZulu-Natal Congella, Durban, South Africa, E-mails: naidoos71@ukzn.ac.za and naidoon@ukzn.ac.za. Leslie London, Centre for Occupational and Environmental Health, Department of Public Health, University of Cape Town, Cape Town, South Africa, E-mail: leslie.london@uct.ac.za. Alex Burdorf, Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, The Netherlands, E-mail: a.burdorf@erasmusmc.nl. Hans Kromhout, Institute for Risk Assessment Sciences, Environmental Epidemiology Division, Utrecht University, Utrecht, The Netherlands, E-mail: h.kromhout@uu.nl.

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