Abstract

1.1. Background: Malaria remains a major public health challenge in Mozambique. Housing quality is a critical environmental determinant of malaria transmission, as precarious housing may facilitate increased exposure to mosquito vectors. This study aimed to assess the relationship between housing conditions, other infrastructural factors, and malaria incidence across the three regions of Mozambique.
1.2. Methods: We analyzed national annual malaria case data from 2012 to 2020. Predictor variables included demographics, built infrastructure, health services, housing type (conventional, mixed, traditional), and climatic factors. Statistical analyses included descriptive comparisons between regions (ANOVA/Kruskal-Wallis) and multiple linear regression models to identify factors associated with malaria incidence.
1.3. Results: Nationally, the incidence of malaria showed a significant increasing trend over time (+10.14 cases per 1,000 inhabitants per year). Conventional housing was significantly associated with lower national incidence (-7.12 cases per 1,000 inhabitants), while mixed housing was associated with higher incidence (+6.24). Regional analysis revealed that the northern region had the highest burden of malaria cases. The protective effect of conventional housing was most pronounced in the southern region, where it was associated with a reduction of 59.6 cases per 1,000 inhabitants in the adjusted model. Increased built infrastructure was also associated with significantly lower incidence in the southern and northern regions.
1.4. Conclusion: Housing quality and infrastructure development are key determinants of malaria incidence in Mozambique. The strong protective association of conventional housing suggests that structural interventions to improve housing should be integrated into malaria control strategies. A holistic approach that combines housing improvements with existing measures is crucial for reducing the malaria burden.