Merga Hailu, Degefa Teshome, Birhanu Zewdie, Tadele Afework, Lee Ming-Chieh, Yan Guiyun, Yewhalaw Delenasaw
Department of Epidemiology, Institute of Health, Jimma University, Jimma, Ethiopia.
School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia.
Malar J. 2025 Apr 19;24(1):131. doi: 10.1186/s12936-025-05368-9.
Malaria control in African cities faces challenges mainly due to unplanned urbanization and the spread of Anopheles stephensi. Urbanization is changing malaria dynamics, driven by environmental changes and population growth, with nearly 70% of people projected to live in urban areas by 2050. This scoping review maps the epidemiology of urban malaria in sub-Saharan Africa, identifying research gaps and guiding strategies for control and elimination.
A structured search across multiple databases was performed using predefined eligibility criteria to select articles. Accordingly, PubMed, Medline EBSCO, Google scholar, Science direct, Cochrane library and grey literature sources were searched for relevant articles. The Joanna Briggs Institute (JBI) guidelines were followed for evidence selection, data extraction, and presentation of findings. Peer-reviewed and gray literature published in English after 2014 that reported on the prevalence, incidence, or risk factors of urban malaria in sub-Saharan Africa was included in the review.
Of the 2459 records identified from various databases, 32 articles were selected for review. A majority of those reviewed studies were community-based studies conducted in urban settings of sub-Saharan African countries. This review found the prevalence of malaria between 0.06% and 58%. This heterogeneity in prevalence is due to differences in diagnostic methods, study design, population characteristics, diagnostic methods, and environmental factors. A majority of those reviewed studies reported the prevalence between 10 and 30% with Plasmodium falciparum and Plasmodium vivax the dominant species. The review identified key factors associated with urban malaria infection, including socioeconomic status, travel history, prior infection, proximity to water sources, availability of vegetation in the compound, temperature, humidity, livestock ownership, and ITN utilization.
This review found a high prevalence of urban malaria infection in sub-Saharan Africa and there was regional variation. Sociodemographic and socioeconomic status, travel history, ITN utilization, previous history of malaria infection and environmental factors like proximity to water sources, presence of vegetation, temperature, humidity, and livestock ownership were identified as factors associated with urban malaria infection. Hence, there is a need for a comprehensive approach to control urban malaria, including environmental management, improved diagnostics and treatment, socio-economic interventions, and better urban planning.
非洲城市的疟疾防控面临挑战，主要原因是城市化无序发展以及斯氏按蚊的传播。城市化正在改变疟疾动态，这是由环境变化和人口增长驱动的，预计到2050年将有近70%的人口居住在城市地区。本综述旨在梳理撒哈拉以南非洲城市疟疾的流行病学情况，找出研究空白，并为控制和消除疟疾提供策略指导。
使用预先设定的纳入标准在多个数据库中进行结构化检索以筛选文章。据此，在PubMed、Medline EBSCO、谷歌学术、科学Direct、考克兰图书馆和灰色文献来源中搜索相关文章。遵循乔安娜·布里格斯研究所（JBI）的指南进行证据筛选、数据提取和结果呈现。纳入2014年后发表的、以英文撰写的、报告了撒哈拉以南非洲城市疟疾患病率、发病率或危险因素的同行评议文献和灰色文献。
从各个数据库中识别出2459条记录，筛选出32篇文章进行综述。大多数综述研究是在撒哈拉以南非洲国家城市地区开展的基于社区的研究。本综述发现疟疾患病率在0.06%至58%之间。患病率的这种异质性是由于诊断方法、研究设计、人群特征、诊断方法和环境因素的差异所致。大多数综述研究报告的患病率在10%至30%之间，恶性疟原虫和间日疟原虫是主要种类。该综述确定了与城市疟疾感染相关的关键因素，包括社会经济地位、旅行史、既往感染、靠近水源、居住地植被情况、温度、湿度、牲畜饲养情况以及长效驱虫蚊帐的使用情况。
本综述发现撒哈拉以南非洲城市疟疾感染患病率很高，且存在区域差异。社会人口统计学和社会经济地位、旅行史、长效驱虫蚊帐的使用情况、既往疟疾感染史以及诸如靠近水源、植被存在情况、温度、湿度和牲畜饲养情况等环境因素被确定为与城市疟疾感染相关的因素。因此，需要采取综合方法来控制城市疟疾，包括环境管理、改进诊断和治疗、社会经济干预以及更好的城市规划。
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