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Occupations at high risk for malaria in Zanzibar: a case-control study, may-august 2023.
Geofrey Makenga1, Sarah Gallalee2, Humphrey Mkali3
1PMI Dhibiti (Control) Malaria Project, Population Services International, Dar es Salaam, United Republic of Tanzania. geofmacky@gmail.com.
Malaria Journal
|August 20, 2025
Summary
In Zanzibar, night watchmen, construction workers, and farmers face higher malaria risks, especially in urban areas. Targeted interventions for these high-risk populations are crucial for malaria elimination efforts.
Area of Science:
- Epidemiology
- Public Health
- Infectious Disease Control
Background:
- Malaria cases often cluster geographically and within specific subpopulations during elimination phases.
- Occupation and mobility are key factors increasing individual malaria infection risk.
Purpose of the Study:
- To identify malaria high-risk populations (HRPs) in Zanzibar.
- To explore associations between risk factors and local malaria infection.
Main Methods:
- A case-control study was conducted in urban and rural districts of Zanzibar.
- 197 malaria cases and 557 controls were recruited and frequency matched by age and sex.
- Logistic regression analyzed risk factors for malaria infection.
Main Results:
- In urban areas, night watchmen/police, construction workers, and farmers showed significantly higher odds of malaria infection.
- High-risk behaviors in urban settings included night-time activities, outdoor meals, and intra-Zanzibar travel.
- In rural areas, outdoor night-time activities and outdoor meals were identified as risk factors; no specific high-risk occupations were found.
Conclusions:
- Targeted interventions for specific occupational groups can effectively reduce malaria in urban Zanzibar.
- Understanding localized risk factors is essential for malaria elimination strategies.
