Research article
Background: Malaria prevalence and transmission intensity in Tanzania is heterogeneous with spatial and temporal
variations between geographical areas and ecological systems. The objective of this study was to determine the
prevalence of malaria, anaemia and nutritional status in relation to livelihoods, ecosystem and health systems in
Kilosa District in central Tanzania.
Methods: This study was conducted in four villages, two characterised by rice irrigation ecosystem and the other
two by dry savannah ecosystem and pastoral livelihoods. In each ecosystem, one of the villages had a healthcare
facility. Schoolchildren were screened for malaria infection using malaria rapid diagnostic test (mRDT) and microscopy
and they were assessed for their anaemia and nutritional statuses.
Results: A total of 1,019 school children (age = 4–16 years) were screened for malaria infection. The overall prevalence
of Plasmodium falciparum infection was 10.6 % and 4.5 % by mRDT and microscopy, respectively. Children from
pastoral villages had lower (2.9 %) prevalence of malaria than their counterparts (18.2 %) in the rice irrigation villages.
A significantly high risk of malaria was observed among children in rice irrigation than in the pastoral ecosystem (OR:
0.13; 95%CI 0.07, 0.23). Children living in areas with health care facilities had a low odd of malaria infection by
45 % (OR: 0.55; 95 % CI = 0.35, 0.86). Overall, the prevalence of anaemia in the district was 43.4 % (n = 775); and
58.3 % of those with severe anaemia were among children from the pastoral villages. Anaemia was significantly
higher among children not using mosquito nets (p = 0.049); and among those with malaria infection (p <0.001).
The majority (96 %) of the children had Body Mass Index less than 18.5 kg/m2 which indicate high proportion of
underweight.
Conclusion: There are significant variations in the risk of acquiring malaria infection between different ecosystems and
livelihoods. These findings suggest that malaria control programmes must take into account ecosystems and livelihoods
of the targeted population through an integrated management of malaria and nutrition approach.
International Development Research Centre of Canada