Assessing the correlation between malaria case mortality rates and specific socioeconomic factors

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.