Is Plasmodium falciparum malaria incidence and severity in holo-endemic areas affected by gender?

Malaria is a debilitating and deadly disease that threatens 40% of the world population, causing 435000 deaths every year and resulting in untold suffering and human misery around the world – predominantly in Africa. It has been suggested that malaria has a different impact on women and men, both social and biological factors contribute to this difference. The study enrolment was conducted between June and October 2018 at the HopeXchange Medical Centre (HXC), located in the suburbs of Kumasi (Ghana). A sequential mixed-methods design comprising qualitative (focus group discussions, FGDs; in-depth interviews, IDI) and quantitative methods was used. Hundred and-twenty-four individuals were diagnosed with malaria at HXC and enrolled. This study found a low ownership (40%) and use (19%) of insecticide-treated nets (ITNs) compared to the national data (57%). Most of malaria cases were women, less educated and presenting more external risk factors to get infected. The study unexpectedly found a decreased ITN use and an increased self-medication attitude among respondents. Furthermore, our data suggest that women are considerably more exposed than men to get malaria infections, especially due to their prolonged exposure to mosquito bites during the most dangerous hours. Our study highlighted the need to invest in future malaria policies and research tools more focused on people’s social and behavioral aspects and not entirely concentrated on biological or clinical factors.