The epidemiology of malaria and anaemia in the Bonikro mining area, central Côte d'Ivoire.

Background: The epidemiology of malaria and anaemia is characterized by small-scale spatial and temporal heterogeneity, which might be influenced by human activities, such as mining and related disturbance of the environment. Private sector involvement holds promise to foster public health, including the prevention and control of malaria and anaemia. Here, results from a cross-sectional epidemiological survey, conducted in communities that might potentially be affected by the Bonikro Gold Mine (BGM) in Côte d'Ivoire, are reported.
Methods: In December 2012, a cross-sectional survey was carried out in seven communities situated within a 20-km radius of the BGM in central Côte d'Ivoire. Capillary blood samples were obtained from children aged six to 59 months. Samples were subjected to a rapid diagnostic test (RDT) for Plasmodium falciparum detection, whilst haemoglobin (Hb) was measured to determine anaemia. Additionally, mothers were interviewed with a malaria-related knowledge, attitudes and practices questionnaire.
Results: A total of 339 children and 235 mothers participated in the surveys. A positive RDT for P. falciparum was found in 69% of the children, whilst 72% of the children were anaemic (Hb <11 g/dl). Plasmodium falciparum infection was significantly associated with anaemia (odds ratio (OR) 7.43, 95% confidence interval (CI) 3.97-13.89), access to a health facility (OR 5.59, 95% CI 1.81-17.32) and age (OR 0.04, 95% CI 0.01-0.12; youngest (six to 11 months) versus oldest (48-59 months) age group). Less than a quarter of mothers knew that malaria is uniquely transmitted by mosquitoes (22.3%, 95% CI 16.8-27.7%). Misconceptions were common; most of the mothers believe that working in the sun can cause malaria.
Conclusions: Malaria and anaemia are highly endemic in the surveyed communities around the BGM project area in Côte d'Ivoire. The data presented here provide a rationale for designing setting-specific interventions and can be utilized as a benchmark for longitudinal monitoring of potential project-related impacts due to changes in the social-ecological and health systems.