In African growing cities, vector-borne diseases (such as malaria and dengue) contribute to a large burden of childhood morbidity and mortality. During the peak of transmission, environmental factors can have an influence on those fevers, apart from the individual and household characteristics. A household survey conducted in 2008 in Dakar was completed by a community questionnaire on environmental threats that could be factored into multilevel analyses. Using a randomized sample of 7,300 children from 3,000 households dispatched within 50 neighborhoods, a three-level modeling process is presented. Rates of recent fever varied substantially from one neighborhood to another, ranging between 10 and 37 %. Findings indicate that the onset of fever is influenced by factors from all three hierarchical levels, with neighborhood factors playing a relatively lower role than the other two. Among the environmental factors, the effect of environmental sanitation is particularly interesting
Dos Santos, S., Rautu, I., Diop, M., Abdou Illou, M. M., Ndonky, A., Le Hesran, J.-Y., & Lalou, R. (2014). The influence of environmental factors on childhood fever during the rainy season in an African city: a multilevel approach in Dakar, Senegal. Population and Environment, 36(4), 429-451. https://doi.org/10.1007/s11111-014-0224-1 (Original work published 2014)