Spatial and epidemiological drivers of Plasmodium falciparum malaria among adults in the Democratic Republic of the Congo.

摘要: Background Adults are frequently infected with malaria and may serve as a reservoir for further transmission, yet we know relatively little about risk factors adult infections. In this study, assessed among adults using samples from the nationally representative, cross-sectional 2013–2014 Demographic Health Survey (DHS) conducted in Democratic Republic of Congo (DRC). We explored differences by urbanicity. Methods Plasmodium falciparum infection was determined PCR. Covariates were drawn DHS to model individual, community environmental-level infection. Additionally, used deep sequencing data estimate community-level proportions drug-resistant infections included these estimates potential factors. All identified associations Results A total 16 126 included. Overall prevalence 30.3% (SE=1.1) PCR; province-level ranged 6.7% 58.3%. Only 17% individuals lived households at least one bed-net every two people, recommended WHO. Protective increasing within-household coverage (Prevalence Ratio=0.85, 95% CI=0.76–0.95) modern housing (PR=0.58, 95% CI=0.49–0.69). Community-level protective increased median wealth (PR=0.87, 95% CI=0.83–0.92). Education, wealth, showed cities but not rural areas. Conclusions The DRC continues suffer high burden malaria; interventions that target high-risk groups sustained investment control sorely needed. Areas should be prioritised largest reservoirs transmission.