Background Even though malaria cases have drastically come down in the last decade, malaria remains a serious public health concern in many parts of India. National Framework for Malaria Elimination in India (2016–2030) has been launched with the goal to eliminate malaria by 2030. Understanding the socio-economic and household determinants of malaria at the national level will greatly aid India’s malaria elimination efforts. Methods The data from Longitudinal Ageing Survey of India (LASI) Wave 1 (2017–2018) survey comprising 70,671 respondents ≥ 45 years across all the States and Union Territories were used for the analysis. Simple and multiple logistic regressions were used to obtain the unadjusted and adjusted odds ratio respectively of the socio-economic and household variables. Results The major socio-economic variables that increase the likelihood of malaria are caste (‘scheduled tribes’), low education levels and rural residence. The scheduled tribes have 1.8 times higher odds of malaria than the scheduled castes (AOR: 1.8; 95% CI: 1.5–2.1). Respondents with high school education (6–12 grade) (AOR: 0.7; 95% CI: 0.6–0.8) and college education (AOR: 0.5; 95% CI: 0.4–0.6) had a very low risk of malaria than those with no school years. Rural residence and occupation (agriculture and allied jobs) also increases the odds of malaria. The major housing determinants are household size (≥ 6), housing type (kutcha), use of unclean fuel, outside water source, improper sanitation (toilet facilities) and damp wall/ceiling. Conclusions The study has identified the major socio-economic and housing factors associated with malaria in adults aged 45 and above. In addition to vector and parasite control strategies in the tribal dominated regions of India, improving literacy and housing conditions may help India’s malaria elimination efforts.

Malaria is endemic in several tribal-dominated districts in India. Partnering and educating the tribal communities are key to malaria elimination efforts. A Knowledge, Attitude, and Practices (KAP) study was undertaken at Kandhamal, a tribal dominated malaria endemic district in the state of Odisha, to assess the gaps in malaria awareness in this community for focused public health interventions. To assess the knowledge, attitudes, and practices on malaria in the tribal-dominated regions of Kandhamal district, Odisha. A descriptive KAP survey was carried out in the Kandhamal district at the household level. Three hundred households/respondents from 6 blocks distributed in 44 villages were selected through convenient sampling. Statistical analysis was carried out using SPSS (version 24), and ArcGIS software was used for GIS mapping. The respondents had good knowledge on the major malaria symptoms. Witchcraft, contaminated food/water, and contact with a malaria case were thought to transmit malaria by 5.3%, 14.3%, and 9.7% of respondents, respectively, and these clusters have been mapped by GIS. Logistic regression identified reduced level of education and open source of water supply to have a strong association with the misconceptions regarding malaria among the respondents. Knowledge and attitude regarding malaria were found to be associated with residence in a hilly area and an open source of water supply, respectively. Overall, the participants in Kandhamal had good KAP on malaria. The clusters with poor knowledge could be the target of focused public health interventions.

BackgroundEven though malaria cases have drastically come down in the last decade, malaria remains a serious public health concern in many parts of India. National Framework for Malaria Elimination in India (2016-30) has been launched with the goal to eliminate malaria by 2030. Understanding the socio-economic and household determinants of malaria at the national level will greatly aid in India’s malaria elimination efforts.MethodsThe data from Longitudinal Ageing Survey of India (LASI) Wave 1 (2017-2019) survey comprising 70671 respondents ≥45 years across all the States and Union Territories were used for analysis.Simple and multiple logistic regressions were used to obtain the unadjusted and adjusted odds ratio respectively of the socio-economic and household variables.ResultsThe major socio-economic variables that increase the likelihood of malaria are caste (Schedule Tribes), rural residence and low education levels.The scheduled tribes have 1.8 times higher odds of malaria than the scheduled castes (AOR: 1.8; 95% CI: 1.5-2.1). Respondents withhigh school education (6-12 grade) (AOR: 0.7; 95% CI: 0.6-0.8) and college education (AOR: 0.5; 95% CI: 0.4-0.6) had a very low risk of malaria than those with no school years. Rural residence and occupation (agriculture and allied jobs) also increases the odds of malaria. The major housing determinants are household size (≥6), housing type (kutcha), use of unclean fuel, outside water source, improper sanitation (toilet facilities) and damp wall/ceiling.ConclusionsIn addition to vector and parasite control strategies, improving literacy and housing conditions, especially in tribal dominated regions will greatly aid in India’s malaria elimination efforts.