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Measuring socioeconomic inequalities in relation to malaria risk: a comparison of metrics in rural Uganda

Tusting, Lucy S.; Rek, John; Arinaitwe, Emmanuel; Staedke, Sarah G.; Kamya, Moses R.; Bottomley, Christian; Johnston, Deborah; Lines, Jo; Dorsey, Grant; Lindsay, Steve W.

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Authors

Lucy S. Tusting

John Rek

Emmanuel Arinaitwe

Sarah G. Staedke

Moses R. Kamya

Christian Bottomley

Deborah Johnston

Jo Lines

Grant Dorsey

Steve W. Lindsay



Abstract

Socioeconomic position (SEP) is an important risk factor for malaria, but there is no consensus on how to measure SEP in malaria studies. We evaluated the relative strength of four indicators of SEP in predicting malaria risk in Nagongera, Uganda. 318 children resident in 100 households were followed for 36 months to measure parasite prevalence routinely every three months and malaria incidence by passive case detection. Household SEP was determined using: (1) two wealth indices, (2) income, (3) occupation and (4) education. Wealth Index I (reference) included only asset ownership variables. Wealth Index II additionally included food security and house construction variables, which may directly affect malaria. In multivariate analysis, only Wealth Index II and income were associated with the human biting rate, only Wealth Indices I and II were associated with parasite prevalence and only caregiver’s education was associated with malaria incidence. This is the first evaluation of metrics beyond wealth and consumption indices for measuring the association between SEP and malaria. The wealth index still predicted malaria risk after excluding variables directly associated with malaria, but the strength of association was lower. In this setting, wealth indices, income and education were stronger predictors of socioeconomic differences in malaria risk than occupation.

Citation

Tusting, L. S., Rek, J., Arinaitwe, E., Staedke, S. G., Kamya, M. R., Bottomley, C., Johnston, D., Lines, J., Dorsey, G., & Lindsay, S. W. (2016). Measuring socioeconomic inequalities in relation to malaria risk: a comparison of metrics in rural Uganda. The American Journal of Tropical Medicine and Hygiene, 94(3), 650-658. https://doi.org/10.4269/ajtmh.15-0554

Journal Article Type Article
Publication Date Jan 1, 2016
Deposit Date Dec 22, 2015
Publicly Available Date Mar 13, 2025
Print ISSN 0002-9637
Electronic ISSN 1476-1645
Publisher American Society of Tropical Medicine and Hygiene
Peer Reviewed Peer Reviewed
Volume 94
Issue 3
Pages 650-658
DOI https://doi.org/10.4269/ajtmh.15-0554
Keywords malaria; socioeconomic; poverty; asset index; Uganda

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