Risk Factors for Contracting Malaria in Nyanga District, Zimbabwe: a Case Control Study

Download Article

DOI: 10.21522/TIJPH.2013.04.04.Art014

Authors : Notion Gombe, Mashizha S, Gunda T


Introduction: A review of Nyanga District malaria weekly surveillance data showed that malaria cases had surpassed the thresholds from week 4 confirming that an outbreak was underway. We investigated the outbreak to determine risk factors associated with contracting malaria.

Methods: A 1:1 Unmatched Case control study was carried out in Nyanga district. Interviewer administered questionnaires and WHO adapted Integrated Disease Surveillance and Response (IDSR) checklists were used to collect information on risk factors and on outbreak response. Data were analysed using Epi-Info 7 statistical software.

Results: Eighty three cases and 83 controls were enrolled into the study. Most (76%) of the under 5 year cases came from villages across the border in Mozambique. Presence of stagnant water bodies near home [OR= 11.06; 95%CI (2.32; 52.68)] was associated with contracting malaria. Consistently sleeping under a net [OR= 0.13; 95% CI (0.03; 0.59)] Use of mosquito repellents [OR= 0.16; 95% CI (0.04; 0.58)] and having received health education on malaria in the past year [OR= 0.19; 95% CI (0.07; 0.52)] were protective against contracting malaria.

Conclusion: The district was not prepared for the outbreak and the outbreak mainly affected children under five years from Mozambique. The risk factor for contracting malaria during the outbreak was presence of stagnant water bodies near homes which facilitated breeding of the vector. Consistently sleeping under a mosquito net, use of mosquito repellents and reported history of receiving health education on malaria in the past year were protective. As a result of this study health education was given to the community.

Keywords: Thresholds, Malaria, Case Control, Risk Factors


[1] Chikwanha TM, Chinhengo TP, Hanyana N : Malaria Outbreak Investigation Mazowe District Mashonaland Central Province, Zimbabwe 2010 (Unpublished)

[2] Centre for Disease Control and Prevention. Malaria accessed from www.cdc.gov/malaria/about/facts.html on 14/02/13

[3] Dhege C, Zizhou S T, Muyengwa P. Malaria Outbreak investigation in Mudzi District 2012.(unpublished)

[4] Ministry of Health and Child Welfare, Zimbabwe: Preliminary Malaria Stratification Report, 2002 accessed from www.rbm.who.int/countryaction/.../naZimbabwe.pdf on 14/02/13

[5] Marape G, Mpeta ET, Ndlovu N: Factors associated with contracting malaria at Mbembeswana, 10 March to 25 April 2008, Zimbabwe (Unpublished)

[6] Mpofu M, Nkomo B.M.M, Kulkarni R, Mabaera B: Malaria Outbreak in Tsholotsho District in Matabeleland North Province, Zimbabwe, 2006 (Unpublished)

[7] Ministry of Health and Child Welfare Zimbabwe: World Health Organisation, United Nations Development Programme and the Global Fund. Guidelines for Management of Malaria in Zimbabwe, Revised December 2009.

[8] Ministry of Health and Child Welfare, World Health Organisation, united nations Development Programme and the Global Fund. Guidelines for management of malaria in Zimbabwe, revised December 2009.

[9] Maenzanise S R, Kusangaya O, Chirenda J, Tshimanga M : Malaria Outbreak Investigation In Msampakaruma, Kariba District, 2004 (Unpublished)

[10] Rasheed S. et al (2000), Economic impact of febrile morbidity and use of permethrin-impregnated bed nets in a malarious area II, Determinants of febrile illness and the cost of their treatment and malaria prevention,. AMJ Trop. Med Hyg. 62: 181-6

[11] WHO: Guidelines for treatment of malaria, Second edition, WHO Library Cataloguing in Publication Data, 2010.

[12] WHO: A commitment to supporting national programs for greater coverage of Malaria control interventions, Annual Report 2006, World Health Organization, 2006

[13] WHO: Malaria Case Management Operational Manual, World Health Organization, Geneva, 2009

[14] World Health Organization :World Malaria Report, 2011, Geneva, 2011

[15] World Health Organization, Global Malaria Action Plan, Roll Back Malaria Partnership, World Health Organization, Geneva, 2008 accessed from http://rbm.who.int/gmap/2-3.html on 14/01/13