Impacts of Deforestation on Childhood Malaria Depend on Wealth and Vector Biology

Ecosystem change can profoundly affect human well-being and health, including through changes in exposure to vector-borne diseases. Deforestation has increased human exposure to mosquito vectors and malaria risk in Africa, but there is little understanding of how socioeconomic and ecological factors influence the relationship between deforestation and malaria risk. We examined these interrelationships in six sub-Saharan African countries using demographic and health survey data linked to remotely sensed environmental variables for 11,746 children under 5 years old. We found that the relationship between deforestation and malaria prevalence varies by wealth levels. Deforestation is associated with increased malaria prevalence in the poorest households, but there was not significantly increased malaria prevalence in the richest households, suggesting that deforestation has disproportionate negative health impacts on the poor. In poorer households, malaria prevalence was 27%-33% larger for one standard deviation increase in deforestation across urban and rural populations. Deforestation is also associated with increased malaria prevalence in regions where