Abraham Degarege|Kristopher Fennie|Dawit Degarege|Shasank Chennupati|Purnima Madhivanan
Improving socioeconomic status may reduce the burden of malaria in sub Saharan Africa: A systematic review and meta-analysis
Addis Ababa University|Florida International University|Florida International University|Government of Ethiopia|Florida International University|Public Health Research Institute Of India|Florida International University
background clear understanding effects housing structure education occupation income wealth malaria help better design socioeconomic interventions control disease literature review summarizes relationship housing structure educational level occupation income wealth epidemiology malaria subsaharan africa ssa methods systematic review metaanalysis conducted following preferred reporting items systematic reviews metaanalyses guidelines protocol study registered prospero idcrd42017056070 international database prospectively registered systematic reviews january 16 2016 available literature searched pubmed embase cinahl cochrane library case studies reported prevalence incidence plasmodium infection stratified socioeconomic status among individuals living ssa included without limits odds ratio relative risk rr together 95 ci pvalues used effect measures heterogeneity assessed using chisquare morans i2 tau2 tests fixed i230 random i230 loglinear doseresponse model used estimate summary rr results removing duplicates screening titles abstracts full text 84 articles found eligible systematic review 75 included metaanalyses fiftyseven studies crosssectional 12 prospective cohort 10 casecontrol five randomized control trials odds plasmodium infection increased among individuals living poor quality houses 213 95 ci 156323 i2 277 uneducated 136 95 ci 119154 i2 7240 farmers occupation 148 95 ci 111185 i2 00 p001 odds plasmodium infection also increased decrease income 102 95 ci 101103 tau20001 wealth index individuals 125 95 ci 118135 tau2 0028 p0001 longitudinal studies also showed increased risk plasmodium infection among individuals living poor quality houses rr 186 95 ci 147225 i2 00 uneducated 127 103150 i2 00 farmers 136 118158 p001 conclusions lack education low income low wealth living poorly constructed houses occupation farming may increase risk plasmodium infection among people ssa public policy measures reduce inequity health coverage well improve economic educational opportunities poor help reducing burden malaria ssa