Analysis of the socio-economic and cultural factors affecting malaria prevention in provinces with high malaria prevalence in Zambia
Keywords:
Social-economic, cultural, factors, malaria prevention, high malaria prevalence provinces, Zambia.
Abstract
Malaria is endemic in all the provinces of Zambia and remains one of the leading causes of morbidity and mortality. Northen, Eastern, Muchinga and Luapula provinces are evidenced by records of high prevalence of malaria despite the implementation of malaria control and prevention strategies aimed at interrupting the disease transmission which include; use of treated mosquito nets, indoor residual spraying, presumptive and treatment therapy among others. The socioeconomic and cultural factors in these provinces were explored to ascertain if they might be contributing factors to the altered effectiveness of malaria control interventions that have proved successful in other provinces. Aim: The aim of this study was to analyze the socio-cultural and economic factors affecting malaria prevention in provinces with high malaria prevalence in Zambia. Methods: A descriptive cross-sectional study was conducted where an interviewer administered questionnaire was served to selective households in the 4 study provinces. Results: A total of 1580 participated in the study giving a response rate of 98.8%.684 were male and 896 were female. Findings suggest practices and beliefs with respect to socio cultural and socio-economic factors had an influence on the success of malaria control interventions in the provinces. Lack and low levels of education had a direct impact on the understanding of malaria prevention, transmission and interventions. Self-medication, use of left over medicines and seeking treatment late was attributed to low-income levels in all the 4 provinces. Type of housing and occupation exposed individuals to malaria infection. Conclusion: Tailoring malaria preventive measures to the socio-cultural and economic practices in the provinces will help in reducing malaria cases in the provinces.References
Ahorlu CK, Koram KA, Weiss MG. Children, Pregnant Women and the Culture of Malaria in Two Rural Communities of Ghana. Anthropol Med. 2007 Aug;14(2):167-81. doi: 10.1080/13648470701381473. PMID: 27268391.
Alan S. Kaufman, Nadeen L. Kaufman.Kaufman Adolescent and Adult Intelligence Test. https://doi.org/10.1002/9781118660584.ese1323
Alan S. Kaufman, John L. Horn.Age changes on tests of fluid and crystallized ability for women and men on the Kaufman Adolescent and Adult Intelligence Test (KAIT) at ages 17–94 years. Archives of Clinical Neuropsychology Volume 11, Issue 2, 1996, Pages 97-121https://doi.org/10.1016/0887-6177(95)00003-8
Castelli F, Sulis G. Migration and infectious diseases. Clin Microbiol Infect. 2017 May;23(5):283-289. doi: 10.1016/j.cmi.2017.03.012. Epub 2017 Mar 20. PMID: 28336382.
CDC: Centers for Disease Control and Prevention, Zambia Country Profile CDC 2021
Central Statistcs Office of Zambia in figures booklet 1964-2015. Government of the republic of Zambia. Lusaka.
Central statistics office of Zambia, CSO, 2020.
Dako-Gyeke M, Kofie HM. Factors Influencing Prevention and Control of Malaria among Pregnant Women Resident in Urban Slums, Southern Ghana. Afr J Reprod Health. 2015 Mar;19(1):44-53. PMID: 26103694.
David A. Larsen, Zunda Chisha, Benjamin Winters, Mercie Mwanza, Mulakwa Kamuliwo, Clara Mbwili, Moonga Hawela, Busiku Hamainza, Jacob Chirwa, Allen S. Craig, Marie-Reine Rutagwera, Chris Lungu, Tokozile Ngwenya-Kangombe, Sanford Cheelo, John M. Miller, Daniel J. Bridges & Anna M. Winters Malaria surveillance in low-transmission areas of Zambia using reactive case detection.
Degarege A, Fennie K, Degarege D, Chennupati S, Madhivanan P. Improving socioeconomic status may reduce the burden of malaria in sub–Saharan Africa: A systematic review and meta-analysis. PLoS One. 2019 Jan 24;14(1):e0211205. doi: 10.1371/journal.pone.0211205. PMID: 30677102; PMCID: PMC6345497.
Ellah Zingani, Given Mtonga, Aubrey Chichonyi Kalungia, Moses Mukosha, Alefa Banda. Socio-economic and Socio-cultural factors affecting malaria control interventions in Zambia: A survey of Milenge district, Luapula Province. Zambia. Journal of Preventive and Rehabilitative Medicine, Vol. 1, No. 1, 2017, pp. 25-33. doi: 10.21617/jprm.2017.0102.4
Emmanuel Chanda, Mulakwa Kamuliwo, Richard W. Steketee, Michael B. Macdonald, Olusegun Babaniyi and Victor M. Mukonka. An Overview of the Malaria Control Programme in Zambia. Volume 2013 | Article ID 495037 | https://doi.org/10.5402/2013/495037
Gysels M, Pell C, Mathanga DP, Adongo P, Odhiambo F, Gosling R, Akweongo P, Mwangi R, Okello G, Mangesho P, Slutsker L, Kremsner PG, Grobusch MP, Hamel MJ, Newman RD, Pool R. Community response to intermittent preventive treatment of malaria in infants (IPTi) delivered through the expanded programme of immunization in five African settings. Malar J. 2009 Aug 10;8:191. doi: 10.1186/1475-2875-8-191. PMID: 19664250; PMCID: PMC2734860.
Hlongwana, K.W., Mabaso, M.L., Kunene,.S, Govender, D. & Maharaj R. Community knowledge, attitudes and practices (KAP) on malaria in Swaziland: A country earmarked for malaria elimination. Malar J 8, 29 (2009). https://doi.org/10.1186/1475-2875-8-29
Isidoros Papaioannou, Jürg Utzinger, Penelope Vounatsou. Malaria-anemia comorbidity prevalence as a measure of malaria-related deaths in sub-Saharan Africa August 2019Scientific Reports 9(1)DOI: 10.1038/s41598-019-47614-6.
J. Gopika, K. Eshwari, Akhilesh Kumar Pandey, Ranjitha S. Shetty. Socio-ecological determinants of malaria transmission risk among population residing in an endemic area of southern province of Karnataka, India. Clinical Epidemiology and Global Health Volume 25, January–February 2024, 101489 https://doi.org/10.1016/j.cegh.2023.101489.
Kyawt Mon Win, Kyaw Lwin Show, Jetsumon Sattabongkot and Pyae Linn Aung.Ownership and use of insecticide-treated nets in Myanmar: insights from a nationally representative demographic and health survey. Malaria journal 23, Article number: 167 (2024) Cite this article.
Mattern C, Pourette D, Raboanary E, Kesteman T, Piola P, Randrianarivelojosia M, Rogier C. "Tazomoka Is Not a Problem". Local Perspectives on Malaria, Fever Case Management and Bed Net Use in Madagascar. PLoS One. 2016 Mar 4;11(3):e0151068. doi: 10.1371/journal.pone.0151068. PMID: 26943672; PMCID: PMC4778873.
Mensah OA, Kumaranayake L. Malaria incidence in rural Benin: does economics matter in endemic area? Health Policy. 2004 Apr;68(1):93-102. doi: 10.1016/j.healthpol.2003.08.005. PMID: 15033556.
Mukumbuta Nawa, Peter Hangoma, Andrew P. Morse & Charles Michelo. Investigating the upsurge of malaria prevalence in Zambia between 2010 and 2015: a decomposition of determinants. Malar J 18, 61 (2019). https://doi.org/10.1186/s12936-019-2698-x
Nguta JM, Mbaria JM, Gakuya DW, Gathumbi PK, Kiama SG. Antimalarial herbal remedies of Msambweni, Kenya. J Ethnopharmacol. 2010 Mar 24;128(2):424-32. doi: 10.1016/j.jep.2010.01.033. Epub 2010 Jan 22. PMID: 20096761.
Nkem Dike, Obinna Onwujekwe , Juliana Ojukwu, Arthur Ikeme, Benjamin Uzochukwu , Elvis Shu Influence of education and knowledge on perceptions and practices to control malaria in Southeast Nigeria. Social Science & Medicine Volume 63, Issue 1, July 2006, Pages 103-106 https://doi.org/10.1016/j.socscimed.2005.11.061
Pell C, Straus L, Andrew EV, Meñaca A, Pool R. Social and cultural factors affecting uptake of interventions for malaria in pregnancy in Africa: a systematic review of the qualitative research. PLoS One. 2011;6(7):e22452. doi: 10.1371/journal.pone.0022452. Epub 2011 Jul 20. PMID: 21799859; PMCID: PMC3140529.
Pullan RL, Sturrock HJ, Soares Magalhães RJ, Clements AC, Brooker SJ. Spatial parasite ecology and epidemiology: a review of methods and applications. Parasitology. 2012 Dec;139(14):1870-87. doi: 10.1017/S0031182012000698. Epub 2012 Jul 19. PMID: 23036435; PMCID: PMC3526959.
Rehana A Salam, Jai K Das, Zohra S Lassi & Zulfiqar A Bhutta act of community-based interventions for the prevention and control of malaria on intervention coverage and health outcomes for the prevention and control of malaria. Infect Dis Poverty 3, 25 (2014). https://doi.org/10.1186/2049-9957-3-25
Ricci F. Social implications of malaria and their relationships with poverty. Mediterr J Hematol Infect Dis. 2012;4(1):e2012048. doi: 10.4084/MJHID.2012.048. Epub 2012 Aug 9. PMID: 22973492; PMCID: PMC3435125.
Sean A. P. Clouston, Josh Yukich & Phil Anglewicz. Social inequalities in malaria knowledge, prevention and prevalence among children under 5 years old and women aged 15–49 in Madagascar. Malaria journal 14, Article number: 499 (2015)
Sharma RK, Rajvanshi H, Bharti PK, Nisar S, Jayswar H, Mishra AK, Saha KB, Shukla MM, Das A, Kaur H, Wattal SL, Lal AA. Socio-economic determinants of malaria in tribal dominated Mandla district enrolled in Malaria Elimination Demonstration Project in Madhya Pradesh. Malar J. 2021 Jan 5;20(1):7. doi: 10.1186/s12936-020-03540-x. PMID: 33402186; PMCID: PMC7786971.
Singh R, Musa J, Singh S, Ebere UV. Knowledge, attitude and practices on malaria among the rural communities in aliero, northern Nigeria. J Family Med Prim Care. 2014 Jan;3(1):39-44. doi: 10.4103/2249-4863.130271. PMID: 24791235; PMCID: PMC4005199.
Snyman K, Mwangwa F, Bigira V, Kapisi J, Clark TD, Osterbauer B, Greenhouse B, Sturrock H, Gosling R, Liu J, Dorsey G. Poor housing construction associated with increased malaria incidence in a cohort of young Ugandan children. Am J Trop Med Hyg. 2015 Jun;92(6):1207-13. doi: 10.4269/ajtmh.14-0828. Epub 2015 Apr 13. PMID: 25870429; PMCID: PMC4458827.
Tanya L Russell, Nigel W Beebe, Robert D Cooper, Neil F Lobo & Thomas R Burkot. Successful malaria elimination strategies require interventions that target changing vector behaviours. Malar J 12, 56 (2013). https://doi.org/10.1186/1475-2875-12-56
Tusting LS, Willey B, Lucas H, et al. Socioeconomic development as an intervention against malaria: a systematic review and meta-analysis. 2013. In: Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK144266/
Valerie R. Louis, Joelle Bals, Justin Tiendrebeogo, Mamadou Bountogo, Heribert Ramroth, Manuela De Allegri, Corneille Traore´, Claudia Beiersmann, Boubacar Coulibaly, Maurice Ye´, Albrecht Jahn, Heiko Becher and Olaf Mu¨ller. Long-term effects of malaria prevention with insecticide treated mosquito nets on morbidity and mortality in African children: randomised controlled trial. Tropical Medicine and International Health doi:10.1111/j.1365-3156.2012. 02990.x Volume 17 no 6 pp 733–741 June 2012
Wagenaar, B.H., Hirschhorn, L.R., Henley, C. et al. Data-driven quality improvement in low-and middle-income country health systems: lessons from seven years of implementation experience across Mozambique, Rwanda, and Zambia. BMC Health Serv Res 17 (Suppl 3), 830 (2017). https://doi.org/10.1186/s12913-017-2661-x
World health organization. Malaria. Fact sheet No.094.2015 Geneva available at http://www.who.int/mediacentre/factsheets/fs094/en World Health Organization.
Malaria Indicator Survey. 2015. http://41.77.4.164:6510/www.makingmalariahistory.org/wpcontent/uploads/2017/06/ZambiaMIS2015_Jan20-nosigs www.who.int/news-room/feature-stories/detail/world-malaria-report2019
World malaria report 2022 world malaria report 2022.pdf (8th December 2022)
www.lusakatimes.com12/16/2020/government-bemoans-increased-malaria-cases.
World health organization, World malaria report 2022; WHO 2022
Zambia National Malaria Indicator Survey (MIS) 2021(MIS)
Zambia Statistics Agency – Quality Statistics for Development 2020 report
Zambia Demographic and Health Survey 2018 [FR361]. ZDHS,2018;
Zambia National Malaria Indicator Survey (MIS,2018). Available at
https://www.path.org>resources>zambia-national-malaria-survey. Zambia populationdemographics.https://worldpopulationreview.com>countries.
Alan S. Kaufman, Nadeen L. Kaufman.Kaufman Adolescent and Adult Intelligence Test. https://doi.org/10.1002/9781118660584.ese1323
Alan S. Kaufman, John L. Horn.Age changes on tests of fluid and crystallized ability for women and men on the Kaufman Adolescent and Adult Intelligence Test (KAIT) at ages 17–94 years. Archives of Clinical Neuropsychology Volume 11, Issue 2, 1996, Pages 97-121https://doi.org/10.1016/0887-6177(95)00003-8
Castelli F, Sulis G. Migration and infectious diseases. Clin Microbiol Infect. 2017 May;23(5):283-289. doi: 10.1016/j.cmi.2017.03.012. Epub 2017 Mar 20. PMID: 28336382.
CDC: Centers for Disease Control and Prevention, Zambia Country Profile CDC 2021
Central Statistcs Office of Zambia in figures booklet 1964-2015. Government of the republic of Zambia. Lusaka.
Central statistics office of Zambia, CSO, 2020.
Dako-Gyeke M, Kofie HM. Factors Influencing Prevention and Control of Malaria among Pregnant Women Resident in Urban Slums, Southern Ghana. Afr J Reprod Health. 2015 Mar;19(1):44-53. PMID: 26103694.
David A. Larsen, Zunda Chisha, Benjamin Winters, Mercie Mwanza, Mulakwa Kamuliwo, Clara Mbwili, Moonga Hawela, Busiku Hamainza, Jacob Chirwa, Allen S. Craig, Marie-Reine Rutagwera, Chris Lungu, Tokozile Ngwenya-Kangombe, Sanford Cheelo, John M. Miller, Daniel J. Bridges & Anna M. Winters Malaria surveillance in low-transmission areas of Zambia using reactive case detection.
Degarege A, Fennie K, Degarege D, Chennupati S, Madhivanan P. Improving socioeconomic status may reduce the burden of malaria in sub–Saharan Africa: A systematic review and meta-analysis. PLoS One. 2019 Jan 24;14(1):e0211205. doi: 10.1371/journal.pone.0211205. PMID: 30677102; PMCID: PMC6345497.
Ellah Zingani, Given Mtonga, Aubrey Chichonyi Kalungia, Moses Mukosha, Alefa Banda. Socio-economic and Socio-cultural factors affecting malaria control interventions in Zambia: A survey of Milenge district, Luapula Province. Zambia. Journal of Preventive and Rehabilitative Medicine, Vol. 1, No. 1, 2017, pp. 25-33. doi: 10.21617/jprm.2017.0102.4
Emmanuel Chanda, Mulakwa Kamuliwo, Richard W. Steketee, Michael B. Macdonald, Olusegun Babaniyi and Victor M. Mukonka. An Overview of the Malaria Control Programme in Zambia. Volume 2013 | Article ID 495037 | https://doi.org/10.5402/2013/495037
Gysels M, Pell C, Mathanga DP, Adongo P, Odhiambo F, Gosling R, Akweongo P, Mwangi R, Okello G, Mangesho P, Slutsker L, Kremsner PG, Grobusch MP, Hamel MJ, Newman RD, Pool R. Community response to intermittent preventive treatment of malaria in infants (IPTi) delivered through the expanded programme of immunization in five African settings. Malar J. 2009 Aug 10;8:191. doi: 10.1186/1475-2875-8-191. PMID: 19664250; PMCID: PMC2734860.
Hlongwana, K.W., Mabaso, M.L., Kunene,.S, Govender, D. & Maharaj R. Community knowledge, attitudes and practices (KAP) on malaria in Swaziland: A country earmarked for malaria elimination. Malar J 8, 29 (2009). https://doi.org/10.1186/1475-2875-8-29
Isidoros Papaioannou, Jürg Utzinger, Penelope Vounatsou. Malaria-anemia comorbidity prevalence as a measure of malaria-related deaths in sub-Saharan Africa August 2019Scientific Reports 9(1)DOI: 10.1038/s41598-019-47614-6.
J. Gopika, K. Eshwari, Akhilesh Kumar Pandey, Ranjitha S. Shetty. Socio-ecological determinants of malaria transmission risk among population residing in an endemic area of southern province of Karnataka, India. Clinical Epidemiology and Global Health Volume 25, January–February 2024, 101489 https://doi.org/10.1016/j.cegh.2023.101489.
Kyawt Mon Win, Kyaw Lwin Show, Jetsumon Sattabongkot and Pyae Linn Aung.Ownership and use of insecticide-treated nets in Myanmar: insights from a nationally representative demographic and health survey. Malaria journal 23, Article number: 167 (2024) Cite this article.
Mattern C, Pourette D, Raboanary E, Kesteman T, Piola P, Randrianarivelojosia M, Rogier C. "Tazomoka Is Not a Problem". Local Perspectives on Malaria, Fever Case Management and Bed Net Use in Madagascar. PLoS One. 2016 Mar 4;11(3):e0151068. doi: 10.1371/journal.pone.0151068. PMID: 26943672; PMCID: PMC4778873.
Mensah OA, Kumaranayake L. Malaria incidence in rural Benin: does economics matter in endemic area? Health Policy. 2004 Apr;68(1):93-102. doi: 10.1016/j.healthpol.2003.08.005. PMID: 15033556.
Mukumbuta Nawa, Peter Hangoma, Andrew P. Morse & Charles Michelo. Investigating the upsurge of malaria prevalence in Zambia between 2010 and 2015: a decomposition of determinants. Malar J 18, 61 (2019). https://doi.org/10.1186/s12936-019-2698-x
Nguta JM, Mbaria JM, Gakuya DW, Gathumbi PK, Kiama SG. Antimalarial herbal remedies of Msambweni, Kenya. J Ethnopharmacol. 2010 Mar 24;128(2):424-32. doi: 10.1016/j.jep.2010.01.033. Epub 2010 Jan 22. PMID: 20096761.
Nkem Dike, Obinna Onwujekwe , Juliana Ojukwu, Arthur Ikeme, Benjamin Uzochukwu , Elvis Shu Influence of education and knowledge on perceptions and practices to control malaria in Southeast Nigeria. Social Science & Medicine Volume 63, Issue 1, July 2006, Pages 103-106 https://doi.org/10.1016/j.socscimed.2005.11.061
Pell C, Straus L, Andrew EV, Meñaca A, Pool R. Social and cultural factors affecting uptake of interventions for malaria in pregnancy in Africa: a systematic review of the qualitative research. PLoS One. 2011;6(7):e22452. doi: 10.1371/journal.pone.0022452. Epub 2011 Jul 20. PMID: 21799859; PMCID: PMC3140529.
Pullan RL, Sturrock HJ, Soares Magalhães RJ, Clements AC, Brooker SJ. Spatial parasite ecology and epidemiology: a review of methods and applications. Parasitology. 2012 Dec;139(14):1870-87. doi: 10.1017/S0031182012000698. Epub 2012 Jul 19. PMID: 23036435; PMCID: PMC3526959.
Rehana A Salam, Jai K Das, Zohra S Lassi & Zulfiqar A Bhutta act of community-based interventions for the prevention and control of malaria on intervention coverage and health outcomes for the prevention and control of malaria. Infect Dis Poverty 3, 25 (2014). https://doi.org/10.1186/2049-9957-3-25
Ricci F. Social implications of malaria and their relationships with poverty. Mediterr J Hematol Infect Dis. 2012;4(1):e2012048. doi: 10.4084/MJHID.2012.048. Epub 2012 Aug 9. PMID: 22973492; PMCID: PMC3435125.
Sean A. P. Clouston, Josh Yukich & Phil Anglewicz. Social inequalities in malaria knowledge, prevention and prevalence among children under 5 years old and women aged 15–49 in Madagascar. Malaria journal 14, Article number: 499 (2015)
Sharma RK, Rajvanshi H, Bharti PK, Nisar S, Jayswar H, Mishra AK, Saha KB, Shukla MM, Das A, Kaur H, Wattal SL, Lal AA. Socio-economic determinants of malaria in tribal dominated Mandla district enrolled in Malaria Elimination Demonstration Project in Madhya Pradesh. Malar J. 2021 Jan 5;20(1):7. doi: 10.1186/s12936-020-03540-x. PMID: 33402186; PMCID: PMC7786971.
Singh R, Musa J, Singh S, Ebere UV. Knowledge, attitude and practices on malaria among the rural communities in aliero, northern Nigeria. J Family Med Prim Care. 2014 Jan;3(1):39-44. doi: 10.4103/2249-4863.130271. PMID: 24791235; PMCID: PMC4005199.
Snyman K, Mwangwa F, Bigira V, Kapisi J, Clark TD, Osterbauer B, Greenhouse B, Sturrock H, Gosling R, Liu J, Dorsey G. Poor housing construction associated with increased malaria incidence in a cohort of young Ugandan children. Am J Trop Med Hyg. 2015 Jun;92(6):1207-13. doi: 10.4269/ajtmh.14-0828. Epub 2015 Apr 13. PMID: 25870429; PMCID: PMC4458827.
Tanya L Russell, Nigel W Beebe, Robert D Cooper, Neil F Lobo & Thomas R Burkot. Successful malaria elimination strategies require interventions that target changing vector behaviours. Malar J 12, 56 (2013). https://doi.org/10.1186/1475-2875-12-56
Tusting LS, Willey B, Lucas H, et al. Socioeconomic development as an intervention against malaria: a systematic review and meta-analysis. 2013. In: Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK144266/
Valerie R. Louis, Joelle Bals, Justin Tiendrebeogo, Mamadou Bountogo, Heribert Ramroth, Manuela De Allegri, Corneille Traore´, Claudia Beiersmann, Boubacar Coulibaly, Maurice Ye´, Albrecht Jahn, Heiko Becher and Olaf Mu¨ller. Long-term effects of malaria prevention with insecticide treated mosquito nets on morbidity and mortality in African children: randomised controlled trial. Tropical Medicine and International Health doi:10.1111/j.1365-3156.2012. 02990.x Volume 17 no 6 pp 733–741 June 2012
Wagenaar, B.H., Hirschhorn, L.R., Henley, C. et al. Data-driven quality improvement in low-and middle-income country health systems: lessons from seven years of implementation experience across Mozambique, Rwanda, and Zambia. BMC Health Serv Res 17 (Suppl 3), 830 (2017). https://doi.org/10.1186/s12913-017-2661-x
World health organization. Malaria. Fact sheet No.094.2015 Geneva available at http://www.who.int/mediacentre/factsheets/fs094/en World Health Organization.
Malaria Indicator Survey. 2015. http://41.77.4.164:6510/www.makingmalariahistory.org/wpcontent/uploads/2017/06/ZambiaMIS2015_Jan20-nosigs www.who.int/news-room/feature-stories/detail/world-malaria-report2019
World malaria report 2022 world malaria report 2022.pdf (8th December 2022)
www.lusakatimes.com12/16/2020/government-bemoans-increased-malaria-cases.
World health organization, World malaria report 2022; WHO 2022
Zambia National Malaria Indicator Survey (MIS) 2021(MIS)
Zambia Statistics Agency – Quality Statistics for Development 2020 report
Zambia Demographic and Health Survey 2018 [FR361]. ZDHS,2018;
Zambia National Malaria Indicator Survey (MIS,2018). Available at
https://www.path.org>resources>zambia-national-malaria-survey. Zambia populationdemographics.https://worldpopulationreview.com>countries.
Published
2024-06-24
How to Cite
1.
Zingani E, Chupa K, Mweshi C, Gondwe E. Analysis of the socio-economic and cultural factors affecting malaria prevention in provinces with high malaria prevalence in Zambia. Journal of Agricultural and Biomedical Sciences [Internet]. 24Jun.2024 [cited 28Sep.2024];7(4). Available from: https://nscme.unza.zm/index.php/JABS/article/view/1219
Section
Biomedical Sciences