Spatio-temporal variation and socio-demographic characters of malaria in Chimoio municipality, Mozambique

Abstract

Background: In Africa, urban malaria is a major concern, since the towns and especially their suburbs are growing quickly. In Mozambique, malaria represents 45 % of all cases of outpatient visits and 56 % of inpatient visits at paediatric clinics. Malaria is a major public health burden in Chimoio Mozambique and few studies on malaria exist. Methods: The study was carried out to establish the spatiality and temporality of malaria and describe socio-demographic characteristics of malaria patients in Chimoio. Weekly malaria data for 9 years (2006-2014) were collected from the district Epidemiological Bulletin and incidence by season, age, gender, and residence was calculated. SPSS version 20 was used for statistical analysis and ArcGis 10.1 was used to produce maps. Results: The annual overall average of malaria incidence was 20.1 % and the attributable fraction (AF) of malaria was 16 %. There were differences in weekly and yearly malaria occurrences throughout the period. There was no difference in malaria cases between male and female patients. Children under 5 years of age are three times more prone to malaria than adults (p < 0.05). Three temporal clusters of malaria were identified: cluster 1, weeks 25-47 with average weekly cases of 618 (sd = 251.9), cluster 2, weeks 18-24 and 48-51 with average weekly cases of 1066 (sd = 317.4). cluster 3, weeks 1-17 and 52 with average weekly cases of 1587 (sd = 722.4). Similarly, three different clusters were identified according to residential areas: cluster 1 (10 %) mostly urban, cluster 2 (22 %) mostly suburbs, cluster 3 (28 %) mostly rural areas. Conclusion: Malaria is increasing in the suburbs, and rural areas present more cases of malaria compared to urban areas. This article is an initial step to understand the dynamics of malaria in Chimoio. Results suggest that malaria varies in time and space, and that precision public health strategy should be used to control malaria occurrence. Studies on weather factors affecting malaria cases, bed net usage, and others should be undertaken.