Malaria Risk Factors in the Peruvian Amazon: A Multilevel Analysis

A multilevel analysis of malaria risk factors was conducted using data gathered from community-wide surveillance along the Iquitos-Mazan Road and Napo River in Loreto, Peru. In total, 1650 individuals nested within 338 households nested within 18 communities were included in the study. Personal travel (Odds Ratios [OR] 2.48; 95% Confidence Interval [CI] = 1.46, 4.21) and other house member's malaria statuses (OR = 2.54; 95% CI = 1.49, 4.32) were all associated with increased odds in having a malaria episode. Having a large household (>5 individuals) (OR = 0.33; 95% CI = 0.12, 0.93), presence of a community health post / secondary school (OR =0.26; 95% CI = 0.08, 0.80) and church (OR = 0.33; 95% CI = 0.30, 0.78) were associated with lower odds of having a malaria episode. Malaria clustering was evident as 54% of the malaria burden occurred in only 6% of the households surveyed.