Living Conditions and Malaria: A Longitudinal Study in a Rural Malaria-Endemic Area of Sri Lanka

Rahini Mahendran Faculty of Medicine, University of Colombo, Colombo, Sri Lanka;

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Sisira Pathirana Malaria Research Unit, Department of Parasitology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka;

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Manuj Chrishantha Weerasinghe Department of Community Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka

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This study was conducted in a rural malaria-endemic community in Sri Lanka in 2014–2015 because malaria was no longer endemic in the area as of November 2012. Data on sociodemographic factors, living conditions, malaria infections, and use of mosquito protection methods during the period from 1990 to 2015 were collected through a household survey in a systematically selected sample of 724 households, covering >10% of the population in the area. Malaria incidence data were obtained from Anti-Malaria Campaign, and Malaria Research Unit of the University of Colombo. A total of 24,549 malaria cases were reported and a considerable improvement in living conditions was noted during the period covered. The association of malaria case incidence with living conditions of the community was evaluated using Spearman Rank Correlation at P <0.05. Sixty-six percent of households reported a history of malaria. The percentage of poorest type of houses (type 1) declined from 38.8% in the 1990–1994 period to 1.6% by 2015, whereas the best houses (type 5) doubled from 49.1% to 92.1% during the same period. Malaria case incidence was reported to be lowest in the best type houses (r = −0.933, P = 0.007), when pipe-borne water was available within the premises (for drinking: r = −0.846, P = 0.034; for personal hygiene: r = −0.859, P = 0.029), when water-sealed sanitary facilities were available (r = −0.956, P = 0.003), and when mosquito nets were used (r = −0.98, P = 0.001). This observed negative association may have been due to reduced human–mosquito contact.

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Author Notes

Financial support: Funding for the study was obtained through a research grant offered by the World Bank funded HETC project, ID: HETC/QIG/W3/Medicine – TOR7. The funders had no roles in study design, data collection and analysis, decision to publish or preparation of the manuscript.

Authors’ addresses: Rahini Mahendran, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka, E-mail: rahini.mahen15@gmail.com. Sisira Pathirana, Institute of Biochemistry, Molecular Biology and Biotechnology, University of Colombo, Colombo, Sri Lanka, E-mail: sisira@ibmbb.cmb.ac.lk. Manuj Chrishantha Weerasinghe, Department of Community Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka, E-mail: manuj@commed.cmb.ac.lk.

Address correspondence to Rahini Mahendran, Faculty of Medicine, University of Colombo, Colombo 08, Sri Lanka. E-mail: rahini.mahen15@gmail.com
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