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. 2024 Dec 18;23(1):373.
doi: 10.1186/s12936-024-05219-z.

Identifying populations at high risk of malaria: a mixed-methods case-control study to inform targeted interventions in Senegal

Tidiane Thiam  1 , Demba Kande  1 , Henry Ntuku  2 , Caterina Guinovart  1   3 , Natalie Galles  1 , Laura Merriman  1 , Moustapha Cissé  1 , Abiboulaye Sall  1 , Ndack Diop  1 , Aichatou Barry Diouf  4 , Mama Moussa Diaw  4 , Mamadou Diop  4 , Baba Camara  4 , Niene Seck  4 , Aliou Ndour  4 , Yakou Dieye  1 , Jennifer Smith  5 , Adam Bennett  1   5
Affiliations

Identifying populations at high risk of malaria: a mixed-methods case-control study to inform targeted interventions in Senegal

Tidiane Thiam et al. Malar J. .

Abstract

Background: Senegal has made significant progress in reducing the burden of malaria, but transmission remains highly heterogeneous, with specific population subgroups likely at higher risk. Consultations with the National Malaria Control Programme (NMCP) and a review of available data identified nomadic pastoralists, gold miners, and Koranic school students as potential high-risk populations (HRPs). This study aimed to evaluate whether these populations are at higher risk of malaria and better characterize their exposure patterns to inform the design of targeted intervention strategies.

Methods: A mixed-methods study was conducted in the districts of Ranérou, Kaolack, and Saraya between November 2020 and December 2021. A formative assessment including key informant interviews (KII) and focus group discussions (FGD) was conducted with non-HRP and HRP members (nomadic pastoralists, gold miners, Koranic school students). A health facility-based case-control study was then conducted in nine health facilities across the three districts. 501 confirmed malaria cases and 1002 non-malaria controls were frequency matched by age and sex with a ratio of 1:2. A standardized questionnaire was administered to collect sociodemographic information, including occupation, use of malaria prevention measures, mosquito exposure, and travel history. Multivariable logistic regression was used to identify malaria risk factors.

Results: KIIs and FGDs indicated that nomadic pastoralists, gold miners and Koranic school students have high exposure to mosquito bites through outdoor sleeping, spending time outside at night and sleeping in informal structures, with important gaps in the coverage of indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs) and limited access to health services. Compared to controls, cases had higher odds of being a nomadic pastoralist (odds ratio (OR) 4.67 95% CI 1.96-11.11) or gold miner (OR 1.92 95% CI 1.20-3.07). No evidence was found of an association with being a Koranic school student (OR 1.39 95% CI 0.80-2.39).

Conclusions: Nomadic pastoralists and gold miners in the study areas are at higher risk of malaria. Targeted interventions are needed to cover gaps in malaria prevention coverage and access to health services.

Keywords: High risk populations; Malaria; Risk factors.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Institutional Review Board approval for this study was obtained from the University of California San Francisco, PATH and the Senegal comite national d’ethique pour la recherche en sante (CNERS). Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Map of Senegal with health facilities included in the study
Fig. 2
Fig. 2
Distribution of cases and controls by age group, gender and district
See this image and copyright information in PMC

References

    1. Senegal Ministry of Health and ICF Macro. Senegal Malaria Indicator Survey 2008–2009. Senegal, Dakar, 2009.
    1. Agence Nationale de la Statistique et de la Démographie (ANSD) and ICF International. Senegal Continuous Demographic and Health Survey 2012–2013. Senegal, Dakar, 2014.
    1. Agence Nationale de la Statistique et de la Démographie (ANSD) and ICF. Senegal Continuous Demographic and Health Survey 2016. Senegal, Dakar, 2017.
    1. Agence Nationale de la Statistique et de la Démographie (ANSD) and ICF. Senegal Continuous Demographic and Health Survey 2017. Senegal, Dakar, 2018.
    1. National Malaria Control Programme Senegal. Malaria National Strategic Plan 2021–2025. Senegal, Dakar, 2021.

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