Description
Background: Following the scalling-up of malaria control strategies in Mali, understanding the changes in age-specific age-specific prevalence of infection and risk factors associated with remain necessary to determine new priorities to progress toward disease elimination. This study aimed to estimate the risk of clinical malaria using longitudinal data across three different transmission settings in Mali.
Methods : Cohort-based longitudinal studies were performed from April 2018 to December 2022. Incidence of malaria was measured through community health center based passive case detection. Generalized estimation equation (GEE) model was used to assess risk factors for clinical malaria.
Results: Between April 2018 and December 2022, three Malian sites recorded 21,453 visits, with Dangassa leading (10,252), followed by Koïla Bamanan (6,374), and Sirakorola (4,827). Gender distribution was balanced, while children aged 5-9 years had the highest visit frequency. Seasonally, visits were higher during the rainy season, particularly in Sirakorola. Malaria incidence was highest from June to November, with Dangassa's peak at 4 per 100 person-months, surpassing Koïla Bamanan and Sirakorola. The generalized estimating equation model indicated significant risk associations with sex, age, season, and year. Females had a lower malaria risk than males, with the highest risk in the 10-14 age group. Dry season risk was notably lower than in the rainy season. Interactions between study area, season, and age group significantly influenced malaria risk, especially during the dry season in Koïla Bamanan and Sirakorola compared to Dangassa..
Conclusion: Determining factors associated with the occurrence of clinical malaria across different ecological settings across the country could help in the development of new strategies aiming to accelerate malaria elimination in area where the malaria transmission remain intense.
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