Associate Professor, Jindal School of Government and Public Policy, O. P. Jindal Global University, Sonipat, Haryana, India.
Independent Consultant, New Delhi, India.
Indian J Public Health. 2023 Apr-Jun;67(2):226-234. doi: 10.4103/ijph.ijph_964_22.
Malaria remains a public health challenge across several African and South-East Asia Region countries, including India, despite making gains in malaria-related morbidity and mortality. Poor climatic and socioeconomic factors are known to increase population vulnerability to malaria. However, there is scant literature from India exploring this link using large population-based data.
This study aims to study the role of climatic and socioeconomic factors in determining population vulnerability to malaria in India.
We used logistic regression models on a nationally representative sample of 91,207 households, obtained from the National Sample Survey Organization (69 round), to study the determinants of household vulnerability.
Households that resided in high (odds ratio [OR]: 1.876, P < 0.01) and moderately high (OR: 3.427, P < 0.01), compared to low climatically vulnerable states were at greater odds of suffering from malaria. Among households that faced the problem of mosquitoes/flies compared to the reference group, the urban households were at higher risk of suffering from malaria (OR: 8.318, P < 0.01) compared to rural households (OR: 2.951, P < 0.01). Households from the lower income quintiles, caste, poor physical condition of their houses, poor garbage management, and water stagnation around the source of drinking water, strongly predicted malaria vulnerability.
Household's vulnerability to malaria differed according to state climatic vulnerability level and socioeconomic factors. More efforts by integrating local endemicity, epidemiological, and entomological information about malaria transmission must be considered while designing malaria mitigation strategies for better prevention and treatment outcomes.
尽管在疟疾相关发病率和死亡率方面取得了进展，但疟疾仍然是包括印度在内的几个非洲和东南亚地区国家的公共卫生挑战。已知恶劣的气候和社会经济因素会增加人口对疟疾的易感性。然而，印度几乎没有利用基于人群的大型数据集来探索这一联系的文献。
本研究旨在研究气候和社会经济因素在确定印度人口对疟疾易感性方面的作用。
我们使用来自国家抽样调查组织（第 69 轮）的 91207 户家庭的全国代表性样本，使用逻辑回归模型来研究家庭脆弱性的决定因素。
与气候脆弱性低的州相比，居住在高（优势比[OR]：1.876，P <0.01）和中高（OR：3.427，P <0.01）气候脆弱性州的家庭更有可能患疟疾。与参考组相比，面临蚊子/苍蝇问题的家庭中，城市家庭患疟疾的风险更高（OR：8.318，P <0.01），而农村家庭则较低（OR：2.951，P <0.01）。与收入较低的五分位数、种姓、房屋状况差、垃圾处理不善以及饮用水源周围的死水等社会经济因素相比，家庭更有可能患疟疾。
家庭对疟疾的易感性因州气候脆弱性水平和社会经济因素而异。在设计疟疾缓解策略时，必须考虑整合疟疾传播的地方性、流行病学和昆虫学信息，以获得更好的预防和治疗效果。
