The online version of this article (doi:10.1186/1475-2875-11-161) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
MCC and MGF designed the study, proposed the conceptual framework, developed the empirical model, gathered and analysed the data, drafted the manuscript, and equally share the authorship of the paper. All authors read and approved the final manuscript.
Malaria is commonly considered a disease of the poor, but there is very little evidence of a possible two-way causality in the association between malaria and poverty. Until now, limitations to examine that dual relationship were the availability of representative data on confirmed malaria cases, the use of a good proxy for poverty, and accounting for endogeneity in regression models.
A simultaneous equation model was estimated with nationally representative data for Tanzania that included malaria parasite testing with RDTs for young children (six-59 months), and accounted for environmental variables assembled with the aid of GIS. A wealth index based on assets, access to utilities/infrastructure, and housing characteristics was used as a proxy for socioeconomic status. Model estimation was done with instrumental variables regression.
Results show that households with a child who tested positive for malaria at the time of the survey had a wealth index that was, on average, 1.9 units lower (p-value < 0.001), and that an increase in the wealth index did not reveal significant effects on malaria.
If malaria is indeed a cause of poverty, as the findings of this study suggest, then malaria control activities, and particularly the current efforts to eliminate/eradicate malaria, are much more than just a public health policy, but also a poverty alleviation strategy. However, if poverty has no causal effect on malaria, then poverty alleviation policies should not be advertised as having the potential additional effect of reducing the prevalence of malaria.
Additional file 1: Details on the conceptual framework [ 23– 57]. (DOC 76 KB)
Authors’ original file for figure 112936_2011_2162_MOESM2_ESM.ppt
Authors’ original file for figure 212936_2011_2162_MOESM3_ESM.ppt
Gallup JL, Sachs J: The economic burden of malaria. Am J Trop Med Hyg. 2001, 64: 85-96. PubMed
McCarthy FD, Wolf H, Wu Y: Malaria and growth. Book Malaria and Growth. 2000, World Bank, Development Research Group, Washington CrossRef
Somi MF, Butler JRG, Vahid F, Njau JD, Kachur SP, Abdulla S: Is there evidence for dual causation between malaria and socioeconomic status? Findings from rural Tanzania. Am J Trop Med Hyg. 2007, 77: 1020-1027. PubMed
WHO: The global burden of disease: 2004 update. 2008, World Health Organization, Geneva
NMCP: Medium term malaria strategic plan - 2008–2013. 2008, Ministry of Health and Social Welfare, National Malaria Control Programme, Dar es Salaam
USAID: President’s Malaria Initiative. FY2011 Malaria Operational Plan (MOP) Tanzania. In Book President’s Malaria Initiative. FY2011 Malaria Operational Plan (MOP) Tanzania. 2011, Available at: http://www.fightingmalaria.gov/countries/mops/fy11/tanzania_mop-fy11.pdf(Assessed June, 2011)
TACAIDS, ZAC, NBS, OCGS: Tanzania HIV/AIDS and Malaria Indicator Survey 2007–08. 2008, Tanzania Commission for AIDS (TACAIDS), Zanzibar AIDS Commission (ZAC), National Bureau of Statistics (NBS), Office of the Chief Government Statistician (OCGS), and Macro International Inc, Dar es Salaam, Tanzania
Filmer D, Pritchett L: Estimating wealth effects without expenditure data - or tears: an application to educational enrollments in states of India. Demography. 2001, 38: 115-132. PubMed
Xie P, Arkin P: A 17-year monthly analysis based on gauge observations, satellite estimates, and numerical model outputs. Bull Amer Meteor Soc. 1997, 78: 2539-2539. 10.1175/1520-0477(1997)078<2539:GPAYMA>2.0.CO;2. CrossRef
Molineaux L: The epidemiology of human malaria as an explanation of its distribution, including some implications for its control. Malaria: principles and practice of malariology. Edited by: Wernsdorfer WH, McGregor I. 1988, Churchill Livingstone, Edinburgh; New York, 913-998.
Martens P, Kovats RS, Nijhof S, Vries Pd, Livermore MTJ, Bradley DJ, Cox J, McMichael AJ: Climate change and future populations at risk of malaria. Global Environ Chang. 1999, 9: 89-107. CrossRef
Sahn DE, Stifel DC: Poverty comparisons over time and across countries in Africa. World Dev. 2000, 28: 2123-2155. 10.1016/S0305-750X(00)00075-9. CrossRef
Sherraden M: Assets and the poor. 1991, ME Sharpe, Inc, NY
Leatherman S, Metcalfe M, Geissler K, Dunford C: Integrating microfinance and health strategies: examining the evidence to inform policy and practice. Health Policy Plan. 2011, 10.1093/heapol/czr014. First published online: February 22, 2011
McGregor IA, Wilson RJM: Specific immunity: acquired in man. Malaria: principles and practice of malariology. Volume 1. Edited by: Wernsdorfer WH, McGregor I. 1988, Churchill Livingstone, Edinburgh; New York, 559-619.
Molineaux L: The epidemiology of human malaria as an explanation of its distribution, including some implications for its control. Malaria: principles and practice of malariology. Volume 1. Edited by: Wernsdorfer WH, McGregor I. 1988, Churchill Livingstone, Edinburgh; New York, 913-998.
Abdullah S, Adazu K, Masanja H, Diallo D, Hodgson A, Ilboudo-Sanogo E, Nhacolo A, Owusu-Agyei S, Thompson R, Smith T, Binka FN: Patterns of age-specific mortality in children in endemic areas of sub-Saharan Africa. Am J Trop Med Hyg. 2007, 77 (Suppl 6): 99-105. PubMed
McCarthy FD, Wolf H, Wu Y: Malaria and growth. Book Malaria and growth. 2000, The World Bank, City CrossRef
Breman JG: The ears of the hippopotamus: manifestations, determinants, and estimates of the malaria burden. Am J Trop Med Hyg. 2001, 64: 1-11. PubMed
Prothero RM: Migration and malaria risk. Health, Risk & Society. 2001, 3: 19-38. CrossRef
Celli A, Celli-Fraentzel A: The history of malaria in the Roman Campagna from ancient times. 1933, Bale & Danielsson, London
Marques AC: Human migration and the spread of malaria in Brazil. Parasitol Today. 1987, : 166-170.
Bloland PB, Williams HA: Malaria Control During Mass Population Movements and Natural Disasters. 2003, National Academies Press, Washington, DC
Konradsen F, Amerasinghe P: Hoek Wvd, Amerasinghe F, Perera D, Piyaratne M: Strong association between house characteristics and malaria vectors in Sri Lanka. Am J Trop Med Hyg. 2003, 68: 177-181. PubMed
Oaks SC, Mitchell VS, Pearson GW, Carpenter CJ: Malaria: obstacles and opportunities. A report of the Committee for the Study on Malaria Prevention and Control: Status Review and Alternative Strategies, Division of International Health, Institute of Medicine. 1991, National Academy Press, Washington, D.C
MacDonald G: The Epidemiology and Control of Malaria. 1957, Oxford University Press, London
Okoko BJ: Acquisition of bed-nets, sleeping-habits, and control of malaria in the Gambia: sociocultural dimension. J Health Popul Nutr. 2005, 23: 388-389. PubMed
Castro MC: Environmental management of anopheles breeding sites in Dar es Salaam. Phase 1: Inventory of drains in selected areas of Dar es Salaam. Final report. Book Environmental management of anopheles breeding sites in Dar es Salaam. Phase 1: Inventory of drains in selected areas of Dar es Salaam. Final report. JICA/IMCP/UMCP/HSPH. 2007.
Keiser J, Utzinger J, Singer BH: The potential of intermittent irrigation for increasing rice yields, lowering water consumption, reducing methane emissions, and controlling malaria in African rice fields. J Am Mosq Control Assoc. 2002, 18: 329-340. PubMed
Boelee E: Malaria in irrigated agriculture. Irrigation and Drainage. 2003, 52: 65-69. 10.1002/ird.71. CrossRef
Keating J, Macintyre K, Mbogo C, Githeko A, Regens JL, Swalm C, Ndenga B, Steinberg LJ, Kibe L, Githure J, Beier JC: A geographic sampling strategy for studying relationships between human activity and malaria vectors in urban Africa. Am J Trop Med Hyg. 2003, 68: 357-365. PubMed
Castro MC, Singer BH: Migration, urbanization and malaria: a comparative analysis of Dar es Salaam, Tanzania and Machadinho, Rondônia, Brazil. In Africa on the move: African migration and urbanisation in comparative perspective. Edited by: Tienda M, Findley S, Tollman S, Preston-White E. 2006, Wits University Press, Johannesburg, 280-307.
Robert V, Macintyre K, Keating J, Trape J-F, Duchemin J-B, Warren M, Beier JC: Malaria transmission in urban sub-Saharan Africa. Am J Trop Med Hyg. 2004, 68: 169-176.
Keiser J, Castro MC, Maltese MF, Bos R, Tanner M, Singer BH, Utzinger J: Effect of irrigation and large dams on the burden of malaria on global and regional scale. Am J Trop Med Hyg. 2005, 72: 392-406. PubMed
Lerer LB, Scudder T: Health impacts of large dams. Environ Impact Asses. 1999, 19: 113-123. 10.1016/S0195-9255(98)00041-9. CrossRef
World Health Organization: Human Health and Dams. Book Human Health and Dams (Editor ed.^eds.). 2000, The World Health Organization's submission to the World Commission on Dams (WCD), City
Keynes JM: The General Theory of Employment, Interest and Money. 1936, Macmillan and co., limited, London
Modigliani F: Life cycle, individual thrift, and the wealth of nations. Am Econ Rev. 1986, 76: 297-313.
Rank MR, Yoon H, Hirschl TA: American poverty as a structural failing: evidence and arguments. J Sociol Social Welfare. 2003, 30: 3-29.
Schiller BR: The Economics of Poverty and Discrimination. 1995, Prentice Hall, Englewood Cliffs, NJ
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