Original article
Risk factors for severe malaria in Bamako, Mali: a matched case-control study

https://doi.org/10.1016/j.micinf.2004.02.007Get rights and content
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Abstract

The aim of this case-control study was to identify epidemiological risk factors for severe malaria among children living in Bamako, a malaria-endemic area. For this, 260 healthy community controls were matched to 130 patients with severe malaria. Conditional multiple logistic regression analysis indicated that all examined independent factors associated with severe malaria are directly related to characteristics of the child’s mother, with the exception of the child’s own yellow fever vaccination history (odds ratio (OR): 1.93, 95% confidence intervals (CI95%) [1.10–3.37]). The following characteristics were all associated with a decreased risk of severe malaria in the child: maternal education (OR: 0.52, CI95% [0.31–0.86]), the mother’s adequate knowledge about malaria (OR: 0.46, 95% CI95% [0.25–0.86]), her use of mosquito bed nets (OR: 0.53, CI95% [0.30–0.92]) and breast-feeding for at least 2 years (OR: 0.57, CI95% [0.33–0.94]). Conversely, chronic maternal disease (OR:̇3.16, CI95% [1.31–7.61]) was associated with an increased risk of severe malaria. These findings strongly support the hypothesis that maternal factors are central to the development of severe malaria in children. Programmes aiming to improve both maternal health and maternal education may reduce the incidence of severe malaria in children and should therefore be advocated in Bamako and in areas with similar epidemiological patterns for malaria.

Keywords

Severe malaria
Plasmodium falciparum
Environmental factors
Children
Maternal factors
Case-control study

Cited by (0)

Parents or guardians of the children were informed about the purpose of the study and gave informed consent before their child was included in the study. The study was approved by the ethics review board of the Faculty of Medicine, Pharmacy and Odonto-Stomatology of the University of Mali.

1

The first two authors contributed equally to this work.