Research

Are there geographic and socio-economic differences in incidence, burden and prevention of malaria? A study in southeast Nigeria

Obinna Onwujekwe^1,2 , Benjamin Uzochukwu^2,3 , Nkem Dike^2,4 , Chijioke Okoli² , Soludo Eze² and Ogoamaka Chukwuogo^2,3

¹  Department of Health Administration and Management, College of Medicine, University of Nigeria, Enugu, Nigeria

²  Health Policy Research Group, Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria, Enugu, Nigeria

³  Department of Community Medicine, College of Medicine, University of Nigeria, Enugu, Nigeria

⁴  Roberta Buffett Center for International & Comparative Studies, Northwestern University, Chicago, USA

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International Journal for Equity in Health 2009, 8:45doi:10.1186/1475-9276-8-45

Published:	23 December 2009

Abstract

Rationale

It is not clearly evident whether malaria affects the poor more although it has been argued that the poor bear a very high burden of the disease. This study explored the socioeconomic and geographic differences in incidence and burden of malaria as well as ownership of mosquito nets.

Methods

Structured questionnaires were used to collect information from 1657 respondents from rural and urban communities in southeast Nigeria on: incidence of malaria, number of days lost to malaria; actions to treat malaria and household ownership of insecticide treated and untreated mosquito nets. Data was compared across socio-economic status (SES) quartiles and between urban and rural dwellers.

Results

There was statistically significant urban-rural difference in malaria occurrence with malaria occurring more amongst urban dwellers. There was more reported occurrence of malaria amongst children and other adult household members in better-off SES groups compared to worse-off SES groups, but not amongst respondents. The average number of days that people delayed before seeking treatment was two days, and both adults and children were ill with malaria for about six days. Better-off SES quartile and urban dwellers owned more mosquito nets (p < 0.05) (treated and untreated).

Conclusion

Malaria occurs more amongst better-off SES groups and urban dwellers in southeast Nigeria. Deployment of malaria control interventions should ensure universal access since targeting the poor and other supposedly vulnerable groups may exclude people that really require malaria control services.