Malaria in Urban vs. Rural Settings

Nagm Eldeen Mohamed Abbker Idreis

Paediatrics Kampala International University Teaching Hospital Ishaka

ABSTRACT

Malaria continues to be a leading cause of morbidity and mortality worldwide, claiming over half a million lives annually, with sub-Saharan Africa accounting for the majority of deaths. Despite substantial global progress, differences in malaria transmission between urban and rural settings persist due to ecological, environmental, socioeconomic, and infrastructural disparities. This review examines how urbanization affects malaria epidemiology, vector habitats, insecticide resistance, healthcare infrastructure, and control strategies. In rural areas, malaria transmission is sustained by abundant natural breeding sites, agricultural practices, and limited healthcare access. Conversely, urban malaria is shaped by artificial breeding habitats such as drains and construction sites, high population density, and urban agriculture, which create localized but persistent transmission. Insecticide resistance particularly to pyrethroids, DDT, and organophosphates poses significant threats to control efforts across both settings, driven by continuous pesticide exposure and urban farming practices. Healthcare infrastructure gaps, including limited access to diagnostics and treatment, further exacerbate the burden in rural areas. Innovative control measures, such as larval management, environmental sanitation, repellent distribution, and integration of novel technologies, are essential to counteract resistance and sustain control gains. Future research should emphasize the spatial heterogeneity of transmission, impacts of climate and land-use change, and urban-rural migration dynamics. Strengthening surveillance systems, tailoring interventions to specific ecological and social contexts, and promoting sustainable, community-led strategies are vital steps toward malaria elimination across Africa.

Keywords: Urban and rural malaria, Vector habitats and resistance, Transmission dynamics, Healthcare infrastructure and Malaria control strategies.

CITE AS: Nagm Eldeen Mohamed Abbker Idreis (2025). Malaria in Urban vs. Rural Settings. RESEARCH INVENTION JOURNAL OF SCIENTIFIC AND EXPERIMENTAL SCIENCES 5(3):118-127. https://doi.org/10.59298/RIJSES/2025/531118127