Abstract:
Background
Various local villages in the Vhembe district of South Africa have experienced high
malaria infection rates together with a high variability of malaria case mortality rates over
the past 20 years. This research project sets out to determine if socioeconomic factors,
(specifically the location of medical facilities and a geographical aspects) have a
significant influence on the varying malaria case mortality rates. The data from this study
could assist societies and authorities in mitigating the negative effects of malaria infections
on human life expectancies through improved socioeconomic development.
Methods
The study used existing medical records of all reported malaria cases in the Vhembe
district between 1998 and 2017. The data comprised malaria cases recorded at 263 medical
facilities that reported 57 974 infections from 850 source locations across the villages and
formal neighbourhoods. The data set was sampled using maximum variation sampling combined with a stratified sampling approach to select the 30 source locations with the
highest reported variations in malaria case mortality. The number of medical facilities
used, distances to the medical facilities, and proximity to significant water sources were
subsequently spatially and statistically analysed for the sample source locations to
determine potential correlations between these factors and the malaria case fatality rates of
the source locations.
Results
The statistical analysis indicated a significant negative correlation between the case
mortality rates and the number of medical facilities used by the sample source locations,
the number of infections reported, and the maximum and mean distances travelled to the
medical facilities used. This suggested that malaria patients from larger communities, those
who had financial or other means to consult more advanced facilities or those with a larger
variety of services had a significantly lower risk of mortality. In addition, the analysis
indicated a positive correlation between the minimum distances travelled to the medical
facilities used and the case mortality rates, indicating that, although maximum and average
travelling distances had a negative correlation, medical facilities situated within the
vicinities of communities could have a positive impact on reducing case mortality rates.
The spatial analysis supported the majority of the findings from the statistical analysis,
except for a small cluster of source locations that need further investigation. Proximity to
significant water bodies was not found to have any significant impact on case mortality
rates.
