Association of housing quality and altitude with malaria infection among school-aged children in mainland Tanzania
Abstract
Background: Malaria remains a major public health concern in Tanzania, with school-aged children carrying a significant burden. This study assessed the impact of housing structure on malaria prevalence among school-aged children.
Methods: A cross-sectional survey was conducted among 6,554 school-age children from 184 districts across all 26 regions, covering 650 public primary schools in mainland Tanzania in 2021. A multistage cluster sampling methodology was used to ensure both geographical and demographic representation.
Results: Residing in improved houses significantly associated with of malaria prevalence among SACs (aOR: 0.48, CI: 0.33–0.70, p < 0.001). Males experienced more malaria infections than females did (aOR: 1.40, CI: 1.14–1.72, p = 0.001). Compared with school-aged children living below 750 m above sea level (m asl), those residing at elevations of 1,250–1,750 m had 53% lower odds of malaria infection (aOR: 0.47; CI: 0.29–0.78; p = 0.003), with an even more noticeable 93% reduction observed among those living above 1,750 m (aOR: 0.07; CI: 0.01–0.36; p = 0.002). Sleeping under an ITN was associated with a 51% lower prevalence of malaria infection (aOR: 0.49, CI: 0.34–0.71, p < 0.001). School-aged children living in urban areas had 63% lower odds of malaria infection than those living in rural areas (aOR: 0.37, CI: 0.21–0.68, p = 0.001).
Conclusion: Housing improvements could complement existing malaria interventions, especially in marginalized rural communities. Male children and those with severe anaemia were most at risk of malaria infection, whereas higher-altitude residence, urban living, and consistent use of insecticide-treated nets were protective variables. These findings highlight the importance of combining established malaria interventions, such as insecticide-treated nets, with context-specific housing and environmental measures tailored to local transmission settings.
Related
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BibTeX
@article{remiji2026association,
title = {{Association of housing quality and altitude with malaria infection among school-aged children in mainland Tanzania}},
author = {Mbaraka John Remiji and Felista Mwingira and Gerald Kiwelu and Tajiri Laizer and Nicodemus Govella and Samson S. Kiware and Frank Chacky},
journal = {BMC Public Health},
year = {2026},
month = nov,
doi = {10.1186/s12889-026-30091-8},
url = {https://link.springer.com/article/10.1186/s12889-026-30091-8},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Association of housing quality and altitude with malaria infection among school-aged children in mainland Tanzania
AU - Mbaraka John Remiji
AU - Felista Mwingira
AU - Gerald Kiwelu
AU - Tajiri Laizer
AU - Nicodemus Govella
AU - Samson S. Kiware
AU - Frank Chacky
PY - 2026
DA - 2026/11/04
JO - BMC Public Health
DO - 10.1186/s12889-026-30091-8
UR - https://link.springer.com/article/10.1186/s12889-026-30091-8
AB - Background: Malaria remains a major public health concern in Tanzania, with school-aged children carrying a significant burden. This study assessed the impact of housing structure on malaria prevalence among school-aged children. Methods: A cross-sectional survey was conducted among 6,554 school-age children from 184 districts across all 26 regions, covering 650 public primary schools in mainland Tanzania in 2021. A multistage cluster sampling methodology was used to ensure both geographical and demographic representation. Results: Residing in improved houses significantly associated with of malaria prevalence among SACs (aOR: 0.48, CI: 0.33–0.70, p < 0.001). Males experienced more malaria infections than females did (aOR: 1.40, CI: 1.14–1.72, p = 0.001). Compared with school-aged children living below 750 m above sea level (m asl), those residing at elevations of 1,250–1,750 m had 53% lower odds of malaria infection (aOR: 0.47; CI: 0.29–0.78; p = 0.003), with an even more noticeable 93% reduction observed among those living above 1,750 m (aOR: 0.07; CI: 0.01–0.36; p = 0.002). Sleeping under an ITN was associated with a 51% lower prevalence of malaria infection (aOR: 0.49, CI: 0.34–0.71, p < 0.001). School-aged children living in urban areas had 63% lower odds of malaria infection than those living in rural areas (aOR: 0.37, CI: 0.21–0.68, p = 0.001). Conclusion: Housing improvements could complement existing malaria interventions, especially in marginalized rural communities. Male children and those with severe anaemia were most at risk of malaria infection, whereas higher-altitude residence, urban living, and consistent use of insecticide-treated nets were protective variables. These findings highlight the importance of combining established malaria interventions, such as insecticide-treated nets, with context-specific housing and environmental measures tailored to local transmission settings.
SN - 1471-2458
ER -