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Impact of Social Determinants on Vector-Borne Parasitic Diseases in Chad: A Case Study of Grand-Sido and Kouh-Est

DOI: 10.4236/ojapps.2025.151008, PP. 110-126

Keywords: Social Determinants of Health, Vector-Borne Parasitic Diseases, Chad

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Abstract:

Background: Social determinants of health (SDOH) significantly influence diseases with environmental components, like vector-borne parasitic diseases. This study aims to examine how these factors influence vector-borne parasitic diseases (VBPDs) transmission in Chad and provide recommendations for policy improvements. Methods: The study adopts the WHO Conceptual Framework of SDOH to compare two regions in Southern Chad: Kouh-Est, which has an ongoing vector control program, and Grand-Sido, which lacks such a program. The study includes both nomadic and sedentary populations to provide a comprehensive understanding of the SDOH influencing VBPDs. Households were randomly selected. Data on sociodemographic characteristics, literacy, knowledge of VBPDs and protective measures, and access to education and health facilities were collected. Results: A total of 202 households from 17 villages, including 820 participants, were surveyed. Agriculture, livestock, and fishing were the main occupations, involving 84.1% of participants. Literacy was low, with 36.7% non-educated, 47.7% completing primary school, 14.5% secondary school, and only 0.3% reaching tertiary education. Most villages lacked schools beyond the primary level, and nomadic populations were significantly less educated than sedentary ones (p < 0.0001). Over 65% of participants recognized malaria vectors, but trypanosomiasis awareness was higher in Kouh-Est (69.4%) than in Grand-Sido (52.9%) (p < 0.001). Less than 1% recognized river blindness vectors. Around 60% used mosquito nets, while 12.8% in Kouh-Est and 25.2% in Grand-Sido used alternative protection methods. A higher percentage of participants in Kouh-Est (19.4%) and in Grand-Sido (10.1%) used no protection (p < 0.001). Conclusion: Educational deficiencies, lack of protective measures against vectors, inadequate healthcare resources, and lifestyle conditions aggravated by poor road infrastructure, limited transportation, and economic constraints contribute to worsened VBPDs outcomes in these rural populations. Addressing these systemic issues in the surveyed communities is essential for improving health equity and VBPDs outcomes in these regions specifically and in similar populations settings more broadly.

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