Urbanization in sub-saharan Africa and implication for malaria control

Area of Science:

• Public Health
• Epidemiology
• Environmental Science

Background:

• Malaria remains a significant cause of illness and death, hindering socioeconomic progress, especially in sub-Saharan Africa.
• Rapid urbanization presents new challenges for malaria control, increasing the disease burden in urban populations.
• Existing control strategies may need adaptation to address the unique epidemiological dynamics in African cities.

Purpose of the Study:

• To assess the risk of malaria transmission in urban settings across Africa.
• To estimate the number of urban dwellers at risk and the potential incidence of malaria cases.
• To propose integrated malaria control strategies for urban environments.

Main Methods:

• Literature review and a modeling approach to analyze entomologic inoculation rates.
• Utilized UN urbanization data, nighttime light satellite imagery, and malaria risk mapping.
• Estimated population at risk and annual clinical malaria incidence in urban African settings.

Main Results:

• Entomologic inoculation rates in cities vary significantly (0-54/year) based on urbanization and living conditions.
• Approximately 200 million people (24.6% of Africa's population) reside in urban areas at risk of malaria.
• Estimated annual incidence of clinical malaria in urban dwellers ranges from 24.8 to 103.2 million cases.

Conclusions:

• Urban malaria control requires improved basic healthcare, early diagnosis, treatment, and preventive measures like insecticide-treated bed nets.
• Integrated strategies, emphasizing environmental management and larviciding in specific sites, are essential.
• Mitigating urban malaria is vital for environmentally and socially sustainable development in Africa.