Socio-economic and Household Determinants of Malaria in Adults Aged 45 and Above: Analysis of Longitudinal Ageing Survey in India (2017-2018)

Abstract BackgroundEven though malaria cases have drastically come down in the last decade, malaria remains a serious public health concern in many parts of India. National Framework for Malaria Elimination in India (2016-30) has been launched with the goal to eliminate malaria by 2030. Understanding the socio-economic and household determinants of malaria at the national level will greatly aid in India’s malaria elimination efforts.MethodsThe data from Longitudinal Ageing Survey of India (LASI) Wave 1 (2017-2019) survey comprising 70671 respondents ≥45 years across all the States and Union Territories were used for analysis.Simple and multiple logistic regressions were used to obtain the unadjusted and adjusted odds ratio respectively of the socio-economic and household variables.ResultsThe major socio-economic variables that increase the likelihood of malaria are caste (Schedule Tribes), rural residence and low education levels.The scheduled tribes have 1.8 times higher odds of malaria than the scheduled castes (AOR: 1.8; 95% CI: 1.5-2.1). Respondents withhigh school education (6-12 grade) (AOR: 0.7; 95% CI: 0.6-0.8) and college education (AOR: 0.5; 95% CI: 0.4-0.6) had a very low risk of malaria than those with no school years. Rural residence and occupation (agriculture and allied jobs) also increases the odds of malaria. The major housing determinants are household size (≥6), housing type (kutcha), use of unclean fuel, outside water source, improper sanitation (toilet facilities) and damp wall/ceiling.ConclusionsIn addition to vector and parasite control strategies, improving literacy and housing conditions, especially in tribal dominated regions will greatly aid in India’s malaria elimination efforts.