Principal component analysis of socioeconomic factors and their association with malaria in children from the Ashanti Region, Ghana

In total, 1,496 children presenting to the hospital were examined for malaria parasites and interviewed with a standardized questionnaire. The information of eleven indicators of the family's housing situation was reduced by PCA to a socioeconomic score, which was then classified into three socioeconomic status (poor, average and rich). Their influence on the malaria occurrence was analysed together with malaria risk co-factors, such as sex, parent's educational and ethnic background, number of children living in a household, applied malaria protection measures, place of residence and age of the child and the mother.The multivariate regression analysis demonstrated that the proportion of children with malaria decreased with increasing socioeconomic status as classified by PCA (p < 0.05). Other independent factors for malaria risk were the use of malaria protection measures (p < 0.05), the place of residence (p < 0.05), and the age of the child (p < 0.05).The socioeconomic situation is significantly associated with malaria even in holoendemic rural areas where economic differences are not much pronounced. Valid classification of the socioeconomic level is crucial to be considered as confounder in intervention trials and in the planning of malaria control measures.Malaria is one of the major public health challenges subverting development in the poorest countries in the world. The direct and indirect costs of malaria are very high and the disease has played a significant role in the poor economic performance of sub-Saharan Africa. Sachs (2002) estimated, that the gross domestic product in these countries would be up to 32% greater today if malaria had been eliminated 35 years ago [1]. In contrast to a retrogressive trend of malaria morbidity and mortality in many areas malaria burden has been increasing in other areas [2]. Factors such as deteriorating health systems, growing drug and insecticide resistance, failure of water management but also socioeconomic, land-use