Factors influencing urban malaria: a comparative study of two communities in the Accra Metropolis.

BACKGROUND As urban centres in Ghana continue to grow, the scale and impact of urban malaria is increasing. OBJECTIVE To compare the prevalence of malaria in two communities and how this may be affected by knowledge, attitudes, socioeconomic status and preventive practices of residents in two communities within the Accra metropolis. METHODS Giemsa-stained thick blood films were examined for malaria parasites in 400 people (200 each from townships with high and low urban status) from May to November 2009. Questionnaires were administered to determine and evaluate demographics of the participants. All participants lived within the two catchment areas, about 20 km apart. RESULTS Average malaria prevalence among participants was 8.75%. Prevalence in Kaneshie (12%: p=0.032) was significantly higher compared to Airport West (5.5%). Illiteracy rate (17.5%), self-medication (81.5%) and the use of coils (21.0%) as a control mechanism was higher among residents of Kaneshie than Airport West. Most of the people (40%) in Kaneshie did not use any form of malaria control method. Insecticide spray was the most preferred malaria control mechanism by the Airport West residents (60.5%). Overall knowledge about malaria, employment status, housing conditions, level of overcrowding and the cost of treatment of malaria was better in Airport West than at Kaneshie. CONCLUSION Malaria prevalence and factors influencing its transmission differs within communities in the same urban area. It is therefore essential to develop control and prevention strategies based on the needs of specific communities.