Malaria experts have long considered the disease to be affected by socioeconomic factors, so researchers from Sudan and the United Kingdom searched the literature to assess whether socioeconomic status is linked to risk of malaria among children up to 15 years old in endemic countries.
Our objective was to stimulate the thinking about socioeconomic development as a malaria intervention, says Steve Lindsay, study coauthor and a disease ecologist at Durham University, United Kingdom.
Lindsay and colleagues searched 4,696 studies published from 1 January 1980 to 12 July 2011 and found 15 studies with statistical data linking malaria risk and socioeconomic development defined to include household assets, household income or parents occupation.
One study was conducted in Yemen and the rest focused on countries in Sub-Saharan Africa: Burkina Faso, Equatorial Guinea, Ethiopia, the Gambia, Ghana, Kenya, Malawi, Rwanda, Tanzania and Uganda.
The researchers used meta-analysis, a type of study which uses statistical methods to combine and analyse results of individual studies, to establish the overall relationship.
Even in poor communities, there was a stark divide between the poorest and the least poor, according to the study published in The Lancet last month (14 September).
Poorest children were twice more likely to be at risk of malaria than those that were least poor, Lindsay tells SciDev.Net.
Lindsay says the study has significant implications for malaria policy in Sub-Saharan Africa, as it helps explain the protective effect of development and how it could be used to control malaria.
He adds that they highlighted housing because its improvements could reduce the likelihood of mosquitoes entering homes at night.
Chris Cotter, a malaria researcher with the Global Health Group at the US-based University of California San Francisco, thinks that a focus on socioeconomic development is a positive shift as long as it compliments other current interventions.
This is a wise step so long as it appropriately balances the need for proven, life-saving interventions such as bed nets, effective drugs and residual spraying with broader economic development, he tells SciDev.Net.
He adds: Countries that have successfully eliminated malaria have struck this balance in the past.
Lindsay hopes that the research will help governments and aid donors view malaria eradication in a different light. I think its just thinking outside the health box, which is really important in looking for new approaches, he says.
Link to full paper in The Lancet*
This article has been produced by SciDev.Nets Sub-Saharan Africa desk.