Malaria infection and associated household level risks in an urban and rural areas of West Bengal, India

Background & objectives: Malaria is one of the critical public health problems globally as well as in India. Recent times have seen an increase in the importance of the possible effects of environmental and demographic factors on the local transmission of malaria. We conducted a community-level study between urban and rural areas to find out the factors associated with malaria infection. Methods: A community-based observational cross-sectional study was conducted between October 2020 and September 2022 among 330 households from urban areas of Chetla, Kolkata and rural areas of Singur district of West Bengal state of India. Households were selected by two stage random sampling method. Study was done by face-to-face interview, review of medical records and observation of the households. SPSS software was used for data analysis. Multivariable logistic regression (hierarchical model) was done and p-value equal to or less than 0.05 was taken as significant. Results: The prevalence of malaria infection among participants and household level risks of malaria infection were found to be 6.1%, 1.8% and 18.8%, 6.7%, respectively in the urban and rural areas. Significant predictors of malaria infection were households with ≥5 family members [AOR=2.91{CI (1.19-7.15)}], households not using any mosquito protective measures [AOR=3.71{CI (1.04-13.13)}], presence of mosquito breeding places [AOR=4.93{CI (1.53-15.93)}], absence of effective window screen [AOR=3.19{CI (1.16-8.71)}], absence of separate kitchen [AOR=2.38{CI (1.06-5.34)}], and inadequate lighting condition in the house [AOR=4.35{CI (1.78-10.64)}]. Interpretation & conclusion: This study provides important insights into the epidemiology of malaria in a high and low-transmission setting in West Bengal, India. Intensified efforts strengthening community mobilization for preventing breeding places for mosquito. Policy should strengthen investment in housing programs that may complement reduction of malaria transmission. Disease reduction effects of Government and local non-governmental organizations should be directed towards those areas in order to decrease disease load.