scholarly journals Risk factors associated with albuminuria in Rwanda: results from a STEPS survey

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Candide Tran Ngoc ◽  
Prebo Barango ◽  
Roger Harrison ◽  
Andrew Jones ◽  
Steven Velabo Shongwe ◽  
...  
Keyword(s):  
Risk Factors ◽  
Developing Countries ◽  
Rural Areas ◽  
Representative Sample ◽  
Vegetable Consumption ◽  
Smoking Status ◽  
Research Question ◽  
Sub Saharan Africa ◽  
Early Screening ◽  
Steps Survey

Abstract Background Non-communicable diseases (NCDs) are a growing burden which affects every part of the world, including developing countries. Chronic kidney disease (CKD) has varied etiology which can result from or complicate other NCDs such as diabetes and cardiovascular diseases. The growing prevalence of NCDs coupled with the increasing age in most developing countries, has seen a marked increase of CKD in these settings. CKD has been described as “the most neglected NCD” and greatly affects the quality of life of patients. It also places a huge economic burden on societies. However, few epidemiological data exist, particularly in sub-Saharan Africa. Assessment of the prevalence of albuminuria as a marker of kidney damage and CKD progression and its main risk factors was thus needed in Rwanda. Methods This study analyzed data collected during the first STEPwise approach to NCD risk factor Surveillance (STEPS) survey in Rwanda, conducted from 2012 to 2013, to assess the prevalence of albuminuria. A multistage cluster sampling allowed to select a representative sample of the general population. Furthermore, descriptive, as well as univariable analyses and multiple logistic regression were performed to respond to the research question. Results This survey brought a representative sample of 6,998 participants, among which 4,384 (62.65%) were female. Median age was 33 years (interquartile range, IQR 26-44), and over three quarters (78.45%) lived in rural areas. The albuminuria prevalence was 105.9 per 1,000 population. Overall, semi-urban and urban residency were associated with lower odds of CKD (odds ratio, OR 0.36, CI 0.23-0.56, p<0.001 and OR 0.34, CI 0.23-0.50, p<0.001, respectively) than rural status. Being married or living with a partner had higher odds (OR 1.44 (CI 1.03-2.02, p=0.031) and OR 1.62 (CI 1.06-2.48, p=0.026), respectively) of CKD than being single. Odds of positive albuminuria were also greater among participants living with human immunodeficiency virus (HIV) (OR 1.64, CI 1.09- 2.47, p=0.018). Gender, age group, smoking status and vegetable consumption, body mass index (BMI) and hypertension were not associated with albuminuria. Conclusion The albuminuria prevalence was estimated at 105.9 per 1,000 in Rwanda. Rural residence, partnered status and HIV positivity were identified as main risk factors for albuminuria. Increased early screening of albuminuria to prevent CKD among high-risk groups, especially HIV patients, is therefore recommended.

scholarly journals Malarial Infection in HIV Infected Pregnant Women Attending a Rural Antenatal Clinic in Nigeria

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
R. S. Houmsou ◽  
B. E. Wama ◽  
S. O. Elkanah ◽  
L. C. Garba ◽  
T. D. Hile ◽  
...  
Keyword(s):  
Risk Factors ◽  
Haemoglobin Level ◽  
Pregnant Women ◽  
Rural Areas ◽  
First Trimester ◽  
Antenatal Clinic ◽  
Severe Anaemia ◽  
Sub Saharan Africa ◽  
Malarial Infection ◽  
Sub Saharan

Malaria still remains a challenging infection affecting the lives of several HIV infected pregnant women in sub-Saharan Africa. This study was undertaken to determine malarial infection in HIV infected pregnant women in relation to sociodemographic and obstetrical factors. The study also assessed relationship between malarial infection and haemoglobin level, CD4+ counts, and ART regimen, as well as predisposing risk factors that influenced occurrence of malarial infection in the women. Thick and thin blood smears were prepared and stained with Giemsa. Haemoglobin level was determined using a hematology analyzer, while the flow cytometry was used to measure CD4+ counts. Sociodemographic and obstetrical parameters were obtained through the administration of questionnaires. Of the 159 HIV infected pregnant women examined, 33.3% (59/159) had malarial infection. Malarial infection was significantly higher in pregnant women who were divorced, 40.24% (33/82) (χ2=5.72; P=0.05), were at their first trimester (4–12 weeks), 54.8% (17/31) (χ2=14.85; P=0.01), had CD4+ = [201–500 cells/μL], 42.42% (42/99) (χ2=10.13; P=0.00), and those that had severe anaemia (<8 dg/L), 100.00% (χ2= 45.75; P=0.00). However, risk factors that influenced the occurrence of malarial infection in the pregnant women were occupation (farming) (AOR=0.226; P=0.03), marital status (divorced) (AOR=2.80; P=0.02), gestation (first trimester) (AOR=0.33; P=0.00), haemoglobin level (Hb < 8 dg/L) (AOR=0.02; P=0.00), and CD4+ counts (low CD4+) (OR=0.40; P=0.05). The study reported endemicity of malaria in HIV infected pregnant women living in rural areas of Benue State, Nigeria. Malarial infection was higher in women that were divorced, and at their first trimester, had low CD4+ count, and had severe anaemia. Farming, divorce, gestation, severe anaemia, and low CD4+ counts were predisposing risk factors that influenced malaria occurrence in the HIV infected pregnant women. It is advocated that HIV infected pregnant women should be properly and thoroughly educated on malaria preventive measures in rural areas so as to avoid unpleasant effect of malaria during their pregnancies.

scholarly journals Prevalence of Hyperhomocysteinaemia and Associated Factors among Ethiopian Adult Population in a 2015 National Survey

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Feyissa Challa ◽  
Tigist Getahun ◽  
Meron Sileshi ◽  
Bikila Nigassie ◽  
Zeleke Geto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Vegetable Consumption ◽  
Adult Population ◽  
Noncommunicable Diseases ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Middle Income ◽  
Steps Survey ◽  
Associated Risk Factors

Hyperhomocysteinaemia (HHcy) is an independent risk factor for major cardiovascular diseases, but data on the prevalence and predictors of HHcy in low- and middle-income countries like Ethiopia are scant. The aim of this study was to estimate the prevalence of HHcy and associated risk factors in the Ethiopian adult population. A cross-sectional survey on risks of noncommunicable diseases (NCDs) using the STEPwise approach to surveillance (STEPS) survey was conducted between April and June 2015. A total of 4,175 study participants were surveyed. Serum homocysteine (Hcy) and metabolic profile were determined using Cobas Integra 400 Plus and CardioChek PA analyzer, respectively. Factors associated with HHcy were determined using logistic regression. The mean serum tHcy concentration was 14.6 μmol/L, with 16.4 μmol/L in males and 13.4 μmol/L in females. Overall, 38% had HHcy, with figures in males (49%) higher than females (30%). Increased age, being male, and high blood pressure and/or taking blood pressure medication, as well as low consumption of fruit and/or vegetables, were independent risk factors for HHcy. In conclusion, the prevalence of HHcy among the adult Ethiopian population is alarmingly high. Improving diets through the promotion of fruit and vegetable consumption is needed to reduce the risk of NCDs.

Gender differences in cardiovascular risk assessment in elderly adults in Ecuador: evidence from a national survey

2018 ◽  
Vol 67 (4) ◽  
pp. 736-742
Author(s):  
Ivan Sisa
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Cardiovascular Risk ◽  
Rural Areas ◽  
Risk Model ◽  
Smoking Status ◽  
Population Based ◽  
Cvd Risk ◽  
Serum Triglycerides ◽  
Traditional Risk Factors

The present study aimed to predict the risk of developing cardiovascular disease (CVD) over a 5-year period and how it might vary by sex in an ethnically diverse population of older adults. We used a novel CVD risk model built and validated in older adults named the Systematic Coronary Risk Evaluation in Older Persons (SCORE OP). A population-based study analyzed a total of 1307 older adults. Analyses were done by various risk categories and sex. Of the study population, 54% were female with a mean age of 75±7.1 years. According to the SCORE OP model, individuals were classified as having low (9.8%), moderate (48.1%), and high or very high risk (42.1%) of CVD-related mortality. Individuals at higher risk of CVD were more likely to be male compared with females, 53.9% vs 31.8%, respectively (p<0.01). Males were more likely to be younger, living in rural areas, had higher levels of schooling, and with the exception of smoking status and serum triglycerides, had lower values of traditional risk factors than females. In addition, males were less likely to require blood pressure-lowering therapy and statin drugs than females. This gender inequality could be driven by sociocultural determinants and a risk factor paradox in which lower levels of the cardiovascular risk factors are associated with an increase rather than a reduction in mortality. These data can be used to tailor primary prevention strategies such as lifestyle counseling and therapeutic measures in order to improve male elderly health, especially in low-resource settings.

scholarly journals RISK FACTORS FOR CARDIOVASCULAR EVENTS IN RURAL NIGERIA: A CROSS SECTIONAL SURVEY AND A REVIEW OF THE CURRENT LITERATURE

2019 ◽  
Vol 9 (4) ◽  
pp. 370-375
Author(s):  
Anthonia A. Ikpeme*,Nchiewe E. Ani, Edoise M. Isiwele, Andrew E. Ekpenyong,Emmanuel E. Ekanem
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Rural Areas ◽  
Demographic Data ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Cross Sectional Survey ◽  
Chi Square ◽  
Cross Sectional ◽  
Cross River State

Introduction: Over 80% of cardiovascular deaths take place in low and middle incomecountries. These cardiovascular deaths are caused by modifiable risk factors. Evidenceis emerging that some of these factors maybe even more prevalent in rural areas whichare generally underserved.Aim: The aim of this study was to record risk factors for cardiovascular disease inrural communities in south southern Nigeria and review some related literature.Methods: A cross sectional study during clinical outreach activities that took placein 2016 to 2018 in several rural and few urban communities in Cross River State,Nigeria. Participating individuals gave full consent and ethical clearance obtained.Socio-demographic data, Anthropometric data and Blood sugar measurements wereobtained. Data extracted was transferred into EXCEL thereafter analysis was doneusing SPSS version 21. p values less than 0.05 were deemed statistically significant.Tests of significance included Anova, chi square and student t- tests.Results: Total population investigated over the 3 year period was 504. (2016-33.1%),(2017 -37.9%), (2018 – 28%) with a Female: Male distribution of 1:1.Most participants tended to be overweight across the years 59.7%, 59.1%, 73.7%,2016, 2017, and 2018 respectively. The prevalence of Hypertension was 10.71%. Nosignificant gender difference in the prevalence of Hypertension (6.94% males to 3.77%females, p=0.097). The prevalence of Diabetes Mellitus was 10.67%. There was nosignificant gender prevalence (6.67% males to 4.00% females, p =0.431)Conclusion: Cardiovascular disease remains relatively uncommon in Sub-SaharanAfrica, despite an increasing prevalence of risk factors, but it’s incidence is rising.Steps should be taken in Sub-Saharan Africa to prevent an epidemic. This involvesdetailed and regular screening for cardiovascular risk factors in rural communities.Key words: RISK FACTORS, Cardio vascular disease, South South Nigeria.

scholarly journals Chronic bronchitis in Aboriginal people—prevalence and associated factors

2013 ◽  
Vol 33 (4) ◽  
pp. 218-225 ◽  
Author(s):  
S Konrad ◽  
A Hossain ◽  
A Senthilselvan ◽  
JA Dosman ◽  
MD Pahwa
Keyword(s):  
Risk Factors ◽  
First Nations ◽  
Chronic Bronchitis ◽  
Rural Areas ◽  
Associated Factors ◽  
Aboriginal People ◽  
Smoking Status ◽  
Aboriginal Peoples ◽  
Cross Sectional ◽  
Factors Associated

Introduction Knowledge about chronic bronchitis (CB) among Aboriginal people in Canada is limited. The aim of this study was to determine the prevalence of CB and its associated factors among Aboriginal people aged 15 years plus. Methods Logistic regression analysis was used on data from the cross-sectional 2006 Aboriginal Peoples Survey to determine risk factors associated with CB. Results CB prevalence was 6.6% among First Nations, 6.2% among Métis and 2.4% among Inuit. Prevalence was higher among females than males (7.2% versus 5.0%). Individuals with CB were more likely to be older, living at a lower income, with a lower educational attainment and residing in rural areas. Smoking status and body mass index were also significantly associated with CB, but their effect differed by sex. Obesity was particularly significantly associated with CB among females compared with males, and current smoking and non-smoking status was significantly associated with CB among females but not males. Conclusion These findings identify factors associated with CB among Aboriginal people. As such, they may represent potentially preventable risk factors that can inform health promotion and disease prevention practices.

P6369Prevalence of severe hypertension in a sub-Saharan African community

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
B Gaye ◽  
A L Janeczek ◽  
X Jouven ◽  
D Luu ◽  
E Marijon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Rural Areas ◽  
Severe Hypertension ◽  
Blood Pressure Measurement ◽  
Target Organ Damage ◽  
Sub Saharan Africa ◽  
Global Health Initiative ◽  
Increased Risk ◽  
Sub Saharan

Abstract Background Individuals with SH have high 10-year risk of cardiovascular disease, especially when additional risk factors or target organ damage are present. Though some data from in-hospital or selected populations are available, there are no studies reporting community-level prevalence of Severe Hypertension (SH) in sub-Saharan Africa. Purpose Using a cross-sectional design in Abidjan (Ivory Coast), we assessed prevalence of Severe Hypertension among adults. Methods Study participants were recruited within the framework of The Heart Fund's global health initiative. Data were collected in August 2016 from 6 randomly selected sites, ensuring representativeness of both urban and rural areas. Blood pressure (BP) was measured twice, 10 minutes apart, after optimal resting time. Blood pressure measurement were standardized between sites and SH was defined as systolic blood pressure ≥180 and/or diastolic blood pressure ≥110 mmHg at both readings. Demographics and data on cardiovascular history/risk factors were collected in the field. Ethics approval for the study was obtained from the National Ethical Committee of Côte d'Ivoire and written informed consent was obtained from all adult patients. Results Among 1,785 subjects examined, 1,182 aged between 18 and 75 years were included in this analysis. The prevalence of SH was 14.1% (12.5% females vs 17.0% males; P=0.03) (Figure). Among participants with severe hypertension, 28.9% were either undiagnosed or untreated. Alarmingly, subjects at high cardiovascular risk (age ≥60 years and/or obese) had even higher prevalence of overall SH (29.6% and 24.9%, respectively) as well as undiagnosed/untreated SH (29.4% and 24.6%). SH prevalence was almost double in urban compared to rural areas (17.0% vs. 9.2%, P=0.02); however, conversely, undiagnosed/untreated SH was significantly higher in rural areas (50.4% vs 21.9%). Compared to normal bodyweight, those who were overweight and obese had a 1.95-fold (95% CI, 1.30–2.93; P<0.001)and 4.24-fold (95% CI, 2.68–6.74; P<0.001)increased odds of SH (adjusting for age and sex), respectively. Similarly, participants ≥60 years had a 6.04-fold (95% CI, 3.93–9.36; P<0.001)increased risk of undiagnosed SH compared to under 50 years. Finally, men had higher odds of SH compared to women (OR 1.71, 95% CI, 1.19–2.47; P=0.004). Figure 1 Conclusion(s) Our community-based study revealed very high prevalence of SH among adults in Abidjan area, with almost one out of every seven having SH. This underscores SH as a growing public health problemin sub-Saharan Africa.More concerning, a significant (almost one third) proportion of them were either undiagnosed or untreated.

scholarly journals The psychosocial well-being of orphans in Southern Africa: the perception of orphans and teachers

2010 ◽  
Vol 6 (2) ◽  
Author(s):  
M W De Witt ◽  
A C Lessing
Keyword(s):  
Developing Countries ◽  
Southern Africa ◽  
Rural Areas ◽  
Well Being ◽  
Sub Saharan Africa ◽  
Life World ◽  
Personal Experiences ◽  
Research Findings ◽  
Sub Saharan ◽  
Developing Settings

The escalation in numbers of orphans in Sub-Saharan Africa has become a human catastrophe. If governments do not deal with this phenomenon as a priority it might spiral beyond control. Very few studies have been done to investigate the psychosocial impact of orphanhood on children and communities in developing countries. Very little is known about the life world of orphans in developing countries and even less is known about factors in these children’s lives which can affect their mental health. The researchers decided to undertake research in three areas in Southern Africa to investigate the psychosocial well-being of orphans and to compare the findings with existing research findings. A survey was done in three rural areas to determine the perceptions of orphans regarding their own personal experiences and emotional feelings which may reflect on psychosocial well-being, as well as the perceptions of teachers working with these orphans. Except for depression, the findings with regard to most of the psychosocial aspects were in accordance with the literature. The most important findings were that bereavement practices and approaches fit for developed communities might be of little value in developing settings. We are, however, more than aware that orphans from developed counties or even urban settings might differ from those of developing or deep rural areas.Keywords: Orphans; psychosocial well-being; bereavement; poverty; stigmatisation 

scholarly journals Risk factors of heart failure among patients with hypertension attending a tertiary hospital in Ibadan, Nigeria: The RISK-HHF case-control study

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245734
Author(s):  
Ayodipupo S. Oguntade ◽  
IkeOluwapo O. Ajayi
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Heart Failure ◽  
Medication Adherence ◽  
Alcohol Consumption ◽  
Vegetable Consumption ◽  
Case Control ◽  
Sub Saharan Africa ◽  
Systemic Hypertension ◽  
Study Population

Aim Hypertension is the leading cause of heart failure (HF) in sub-Saharan Africa. Preventive public health approach to reduce the scourge of HF must seek to understand the risk factors of HF in at-risk populations. The aim of this study was to characterize the risk factors of HF among patients with hypertension attending a cardiology clinic. Methods and results One hundred and one (101) case-control age- and sex-matched pairs were recruited. The study population were adults with a clinical diagnosis of hypertensive HF (cases) and individuals with systemic hypertension without HF. They were interviewed and evaluated for cardiovascular risk factors. Associations between variables were tested with chi square test, Fisher’s exact test and independent sample t test as appropriate. Logistic regression modelling was used to determine the independent risk factors of hypertensive HF (HHF) in the study population while ‘punafcc’ package in stata12 was used to calculate the population attributable fraction (PAF) of the risk factors. Suboptimal medication adherence was the strongest adverse risk factor of HHF (medium adherence aOR: 3.53, 95%CI: 1.35–9.25; low adherence aOR: 9.44, 95%CI: 3.41–26.10) with a PAF of 67% followed by dipstick proteinuria (aOR: 4.22, 95%CI: 1.62–11.02; PAF: 34%) and alcohol consumption/day per 10grams (aOR: 1.23, 95%CI: 1.02–1.49; PAF: 22%). The protective risk factors of HHF were use of calcium channel blockers (aOR 0.25, 95%CI: 0.11–0.59; PAF: 59%), then daily fruits and vegetable consumption (aOR 0.41, 95%CI: 0.17–1.01; PAF: 46%), and eGFR (aOR 0.98, 95%CI: 0.96–0.99; PAF: 5.3%). Conclusions The risk factors of HHF are amenable to lifestyle and dietary changes. Public health interventions and preventive cardiovascular care to improve medication adherence, promote fruit and vegetable consumption and reduce alcohol consumption among patients with hypertension are recommended. Renoprotection has utility in the prevention of HF among hypertensives.

scholarly journals Prevalence and correlates of multiple non-communicable diseases risk factors among adults in Sudan: Results of the first national STEPS survey in 2016

2020 ◽  
Author(s):  
Supa Pengpid ◽  
Karl Peltzer
Keyword(s):  
Risk Factors ◽  
Rural Areas ◽  
Household Income ◽  
Urban Areas ◽  
Communicable Diseases ◽  
Heavy Episodic Drinking ◽  
Government Employees ◽  
Non Communicable Diseases ◽  
Ordinal Logistic Regression Analysis ◽  
Steps Survey

Abstract Background Non-communicable diseases (NCDs) are on the rise in low- and middle-income countries. The aim of this study was to assess the prevalence and correlates of multiple NCD risk factors among adults in Sudan. Methods Cross-sectional nationally representative data were analysed from 7,722 18–69 year-old individuals (median age = 36 years) that took part in the “2016 Sudan STEPS survey.” Results The prevalence of individual NCD risk factors was 94.6% inadequate fruit and vegetable intake, followed by hypertension (31.6%), general overweight/obesity (28.0%), low physical activity (21.3%), current tobacco use (15.7%), raised total cholesterol (13.6%), diabetes (5.9%), and heavy episodic drinking (1.7%). In all, 34.2% had 0–1 NCD risk factor, 33.5% 2 risk factors, and 32.4% 3 or more NCD risk factors. In adjusted ordinal logistic regression analysis, compared to individuals 18–34 years old, persons 50–69 years old were 3.52 times (AOR: 3.52, 95% CI: 2.88–4.31) more likely to have multiple NCD risk factors. Men were 21% (AOR: 1.21, 95% CI: 1.00-1.46) more likely than women to have multiple NCD risk factors. Individuals residing in urban areas were 86% (AOR: 1.86, 95% CI: 1.49–2.32) more likely than individuals residing in rural areas to have multiple NCD risk factors, and compared to persons never married, married participants and persons separated, divorced or widowed persons were 51% (AOR: 1.51, 95% CI: 1.22–1.87) and 74% (AOR: 1.74, 95% CI: 1.22–2.47), respectively, more likely to have multiple NCD risk factors. Compared to persons with less than 500 pounds household income, persons with over 2000 pounds household income were 75% (AOR: 1.75, 95% CI: 1.28–2.38) more likely to have multiple NCD risk factors. Compared to women who cannot read or write, women who had more than primary education were 38% (AOR: 1.38, 95% CI: 1.06–1.80) more likely to have multiple NCD risk factors. Compared to men who were self-employed, engaged in non-paid work, were students or unemployed (able to work), government employees, non-government employees, retired or unemployed (unable to work) had a significantly higher odds of having multiple NCD risk factors. Conclusion Almost one in three participants had three or more NCD risk factors and several associated variables were identified that can facilitate in designing intervention programmes.

scholarly journals Spatial and epidemiological drivers of P. falciparum malaria among adults in the Democratic Republic of the Congo

2020 ◽  
Author(s):  
Molly Deutsch-Feldman ◽  
Nicholas F. Brazeau ◽  
Jonathan B. Parr ◽  
Kyaw L. Thwai ◽  
Jérémie Muwonga ◽  
...  
Keyword(s):  
Risk Factors ◽  
Protective Factors ◽  
Rural Areas ◽  
Democratic Republic ◽  
Public Health Problem ◽  
Community Level ◽  
Sub Saharan Africa ◽  
World Health ◽  
Sequencing Data ◽  
Cross Sectional

AbstractBackgroundMalaria remains a significant public health problem in sub-Saharan Africa. Adults are frequently infected and may serve as a reservoir for further transmission, yet we know relatively little about risk factors for adult infections. In this study, we assessed malaria risk factors amongst adults using samples from the nationally representative, cross-sectional 2013-2014 Demographic and Health Survey (DHS) conducted in the Democratic Republic of Congo (DRC). We further explored differences in risk factors by urbanicity.MethodsPlasmodium falciparum infection was determined by polymerase chain reaction (PCR). Covariates were drawn from the DHS to model individual, community, and environmental level risk factors for infection. Additionally, we used deep sequencing data to estimate the community-level proportions of drug resistant infections and included these estimates as potential risk factors. All identified factors were assessed for differences in associations by urbanicity.ResultsA total of 16,126 adults were included. Overall prevalence of malaria was 30.3% (SE = 1.1) by PCR; province-level prevalence ranged from 6.7-58.3%. Only 17% of individuals lived in households with at least one bednet for every two people, as recommended by the World Health Organization. Protective factors included increasing within-household bednet coverage (PR = 0.85, 95% CI = 0.76 - 0.95) and modern housing (PR = 0.58, 95% CI = 0.49 - 0.69). Community level protective factors included: increased average education and wealth (PR = 0.77, 95% CI = 0.65-0.91; PR - 0.84, 95% CI = 0.80 - 0.89). Education, wealth, and modern housing showed protective associations in cities but not in rural areas.ConclusionsThe DRC continues to suffer from a high burden of malaria; interventions that target high-risk groups and sustained investment in malaria control are sorely needed. Differences in risk factors by urbanicity may be due to differences in transmission intensity or access to resources.

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