Topography-derived wetness indices are associated with household-level malaria risk in two communities in the western Kenyan highlands

Abstract Background Transmission of Plasmodium falciparum generally decreases with increasing elevation, in part because lower temperature slows the development of both parasites and mosquitoes. However, other aspects of the terrain, such as the shape of the land, may affect habitat suitability for...

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Bibliographic Details
Published in:Malaria Journal
Main Authors: Vulule John M, John Chandy C, Lindblade Kim A, Ernst Kacey C, Cohen Justin M, Wilson Mark L
Format: Article in Journal/Newspaper
Language:English
Published: BMC 2008
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Online Access:https://doi.org/10.1186/1475-2875-7-40
https://doaj.org/article/d2a2dde49b4940a69bd4d9cf851f418b
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Summary:Abstract Background Transmission of Plasmodium falciparum generally decreases with increasing elevation, in part because lower temperature slows the development of both parasites and mosquitoes. However, other aspects of the terrain, such as the shape of the land, may affect habitat suitability for Anopheles breeding and thus risk of malaria transmission. Understanding these local topographic effects may permit prediction of regions at high risk of malaria within the highlands at small spatial scales. Methods Hydrologic modelling techniques were adapted to predict the flow of water across the landscape surrounding households in two communities in the western Kenyan highlands. These surface analyses were used to generate indices describing predicted water accumulation in regions surrounding the study area. Households with and without malaria were compared for their proximity to regions of high and low predicted wetness. Predicted wetness and elevation variables were entered into bivariate and multivariate regression models to examine whether significant associations with malaria were observable at small spatial scales. Results On average, malaria case households (n = 423) were located 280 m closer to regions with very high wetness indices than non-malaria "control" households (n = 895) (t = 10.35, p < 0.0001). Distance to high wetness indices remained an independent predictor of risk after controlling for household elevation in multivariate regression (OR = 0.93 [95% confidence interval = 0.89–0.96] for a 100 m increase in distance). For every 10 m increase in household elevation, there was a 12% decrease in the odds of the house having a malaria case (OR = 0.88 [0.85–0.90]). However, after controlling for distance to regions of high predicted wetness and the community in which the house was located, this reduction in malaria risk was not statistically significant (OR = 0.98 [0.94–1.03]). Conclusion Proximity to terrain with high predicted water accumulation was significantly and consistently associated with ...