# Dynamics of Environmental Conditions and Persistence of Malaria, a Tropical Disease in the City of Koudougou in Burkina Faso

Karim Lossiané, Songanaba Rouamba, Joseph Yaméogo

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Karim Lossiané, Songanaba Rouamba, Joseph Yaméogo. Dynamics of Environmental Conditions and Persistence of Malaria, a Tropical Disease in the City of Koudougou in Burkina Faso. European Journal of Theoretical and Applied Sciences, 2025, 4 (1), pp.77-87. 10.59324/ejtas.2026.4(1).10 . hal-05458843

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# Dynamics of Environmental Conditions and Persistence of Malaria, a Tropical Disease in the City of Koudougou in Burkina Faso

Karim Lossiané

<figure><img src="image_2.png" /></figure>

Norbert Zongo University, Koudougou, Burkina Faso

Songanaba Rouamba

<figure><img src="image_3.png" /></figure>

Norbert Zongo University, Koudougou, Burkina Faso

Joseph Yaméogo

<figure><img src="image_4.png" /></figure>

Ziniaré University Center/ Joseph Ki-Zerbo University, Ouagadougou, Burkina Faso;
Institute of Biopaleogeography named under Charles R. Darwin, Złocieniec,
District Drawski, West Pomerania, Poland

## Article History:

Received: 11.11.2025

Revised: 22.12.2025

Accepted: 24.12.2025

Published: 26.12.2025

## Abstract

Malaria is one of the oldest diseases in human history. The first scientific knowledge about this epidemic dates back to Hippocrates (5th century BC). The discovery of Plasmodium, the parasite responsible for malaria, by Alphonse Laveran in 1880 opened up a new and more dynamic front in the fight against this disease. However, socio-environmental factors were largely overlooked in the fight against the disease. This study therefore focuses on the socio-environmental determinants causing the emergence and persistence of malaria in the city of Koudougou. Very few studies have examined the relationship between malaria and the urban environment in medium-sized cities in Burkina Faso. The methodological approach of this research is based on a literature review and field surveys of 372 households in three (03) sectors of the city of Koudougou. The processing method used is essentially based on descriptive statistical analyses. This work shows that socio-environmental factors maintain the morbidity of this disease in the city of Koudougou, based on the results of the surveys compared with data from local health facilities. Indeed, 30% of those surveyed live less than 500 metres from a waste dump and 24% of the same respondents acknowledge the existence of a water source or flood zone near their homes.

**Keywords:** environment, malaria, persistence, Koudougou, Burkina Faso.

**Suggested citation:** Lossiané, K., Rouamba, S., & Yaméogo, J. (2026). Dynamics of Environmental Conditions and Persistence of Malaria, a Tropical Disease in the City of Koudougou in Burkina Faso. *European Journal of Theoretical and Applied Sciences*, 4(1), 77-87. https://doi.org/10.59324/ejtas.2026.4(1).10

## Introduction

Given its impact on populations and the severity of the disease, malaria has long been considered the most serious of all infectious diseases (Mouchet et al. 2004). Today, malaria is a major public health problem. Towards the end of the 19th century, Alphonse Laveran discovered that

Plasmodium was the agent responsible for malaria. The work of Ross in 1897 and Grassi et al. in 1899 revealed that the female Anopheles mosquito is the vector for the transmission of this disease to humans. Nevertheless, this disease continues to cause enormous suffering throughout the world. According to the World Health Organisation (WHO, 2021) report on
malaria, more than 229 million people were affected and 409,000 died worldwide in 2019. Burkina Faso's national malaria control programme estimates that in 2023, the country recorded more than 11 million cases, with 4,355 deaths. The strategies used to combat this disease have evolved over time, although they have not really addressed the environmental causes. Assako et al. ((2005)) that clinical and biological research alone is not enough to eradicate a disease such as malaria. It is clear that the vast majority of research carried out to date has focused on the production of antimalarial drugs. The city of Koudougou is familiar with recurrent episodes of malaria, which is partly linked to environmental conditions. In Burkina Faso, few studies have examined the spatial distribution of malaria at the urban level. This means that certain aspects of this topic have been less explored by scientists, hence the interest of this study. The main objective of this article is to analyse the socio-environmental determinants that perpetuate this disease in Koudougou.

## Methodology

The methodology used for this study consisted of data collection, processing and analysis. Several methods were used to collect information for the study, including social science methods. These included documentary research, surveys, interviews and direct field observations. In addition, photographs were taken to document field observations using a smartphone. GPS was used to georeference waste dumps and water points throughout the study area. This survey took into account exposed and unexposed households, i.e. those close to or located at a certain distance from vulnerable areas.

## Presentation of the Study Area

Located 100 km south-west of Ouagadougou, the city of Koudougou is the capital of the Koudougou department, the Boulkiemdé province and the Centre-West region, according to the administrative division of Burkina Faso. It lies between 2°37' west longitude and 12°25' north latitude. The city has ten (10) sectors and covers an area of approximately 580 km² (Master Plan for Development and Urban Planning

(SDAU), 2012. According to the Urban Profile of the Municipality of Koudougou, the urbanised area in 2005 was estimated at 52.110 km², giving the municipality an urbanisation rate of 40.39%. Its population has been growing for the past twenty years. From 88,184 inhabitants in 2006, it grew to 160,239 inhabitants in 2019, according to the National Institute of Statistics and Demography/General Population and Housing Census (INSD/RGPH), 2019. The city of Koudougou is part of the central plateau of Burkina Faso, with average elevations of around 400 metres. From a hydrographic point of view, the city is located in the middle basin of the Mouhoun River. It is drained by two small tributaries that have given rise to two backwaters, which join upstream of the Issouka reservoir. The waters of these backwaters are more or less perennial and inevitably promote the proliferation of mosquito larvae.

<figure><img src="image_5.png" /><figcaption>Figure 1. Presentation of the Study Area</figcaption></figure>

As part of this study, it was necessary to determine the size of the sample representative of the urban population in order to obtain reliable results. Thus, the formula from Kothari C. R., 2004, was used to estimate the sample size, as it is appropriate in the case of a known finite population. In addition, this formula is ideal for descriptive research. This formula translates as follows:

$$n = \frac{z^2 \cdot p \cdot q \cdot N}{e^2(N - 1) + z^2 \cdot p \cdot q} \quad (1)$$

Where n = sample size (households to be surveyed);
N = total population size (all households in the study area);

$\bar{\zeta}$ = margin coefficient (determined based on the confidence threshold);

e = tolerated margin of error;

p = proportion of populations assumed to have the characteristics sought.

This proportion, which varies between 0 and 1, is the probability of an event occurring. If no value is available for this proportion, it will be set at 50% (0.05); $q = 1-p$. Therefore, $p = 0.5$. Then, $q = 1-0.5 = 0.5$; $\bar{\zeta} = 1.96$ and $e = 0.05$.

The three sectors (6, 8, 10) have a total of 11,839 households. The sample size based on Kothari's mathematical formula is 372, or 29.1% of the households in the city's 10 sectors. William G.'s 1953 formula assigns each sector a sample based on its population size. Thus, 110 households were surveyed in sector 6, 116 in sector 8 and 146 in sector 10. The survey was conducted from June to November 2023, a period of high endemicity of malaria.

<table><caption>Table 1. Target Population Surveyed in the Town of Koudougou</caption><thead><tr><td>Sectors</td><td>Number of households</td><td>Number of households surveyed</td></tr></thead><tbody><tr><td>6</td><td>3 523</td><td>110</td></tr><tr><td>8</td><td>3 656</td><td>116</td></tr><tr><td>10</td><td>4 660</td><td>146</td></tr><tr><td>TOTAL</td><td>11 839</td><td>372</td></tr></tbody></table>

Source: INSD/RGPH, 2019

The data obtained from the survey and interviews were processed using Microsoft Excel 2016 software. Word 2016 software was used for text entry. Geographic Information System (ArcGIS) software was used to produce maps for this research. The results of these various processes are presented in the tables, graphs and maps included in this document.

# Results

## Socio-Demographic Characteristics of the Respondents Surveyed

The aim here was to examine the gender, age and educational level of the households surveyed.

### Sample distribution by gender

Of the 372 households surveyed, 52.41% were female-headed households and 48.58% were male-headed households. This alternative was chosen because the percentage of women exceeds that of men in Burkina Faso. This will enable us to understand women's views on hygiene and malaria at the household level and to gain a broader understanding of the conditions necessary for the onset of this disease. It has also been observed that women are the first to be affected when a family member falls ill.

<table><caption>Table 2. Gender Characterization</caption><thead><tr><th rowspan="2">Study areas</th><th colspan="2">SEX</th></tr><tr><th>Male (%)</th><th>Female (%)</th></tr></thead><tbody><tr><td>6</td><td>66.66</td><td>33.33</td></tr><tr><td>8</td><td>40.70</td><td>59.29</td></tr><tr><td>10</td><td>35.33</td><td>64.66</td></tr><tr><td>Total</td><td>47.58</td><td>52.41</td></tr></tbody></table>

Source: Field data, October 2023

### Age groups of the sample population

<figure><img src="image_6.png" /><figcaption>Figure 2. Age Groups of Households Surveyed</figcaption></figure>

Source: Field data, October 2023

Young people and elderly people were surveyed. In Figure 2 below, the under-20 age group accounts for 1.61%; the 20-30 age group accounts for 39.78%; the 30-40 age group
accounts for 40.32%; and the 40-50 age group accounts for 12.09%. The 50-60 age group accounts for 4.23%. Respondents in this study aged over 60 constitute 1.98% of the sample. The 20-50 age group was taken into account because it has a certain critical spirit and was receptive to our surveys.

## Level of education of the sample population

A total of 47% of respondents were classified in the "none" group, which includes illiterate people, medersa, bantaaré, etc. Respondents who had attained primary education accounted for 28%, those with secondary education for 18% and those with higher education for 7%. This proportionality among respondents will help to understand the perceptions of both groups (literate and illiterate) regarding the risk of contracting malaria and its danger to society. (Figure 3).

<figure><img src="image_7.png" /><figcaption>Figure 3. Educational Attainment of Sampled Households</figcaption></figure>

Source: field data, October 2023

## Environmental Conditions Conducive to the Spread of the Mosquito Responsible for Malaria

**The city of Koudougou : proliferation of solid waste and spread of malaria**

The Koudougou Town Hall has a sanitation department. However, the urban environment is not clean and waste dumps are unevenly distributed across all areas of the town. Photos 1 and 2 show solid waste in areas 10 and 6 near houses.

<figure><img src="image_8.png" /><figcaption>Photo 1. Rubbish Bin in Front of a Gate
Source: LOSSIANE Karim, September 2023</figcaption></figure>

<figure><img src="image_9.png" /><figcaption>Photo 2: Weeds near Homes
Source: LOSSIANE Karim, September 2023</figcaption></figure>

Waste encourages the proliferation of Anopheles breeding sites, and its proximity to urban dwellings increases the risk of malaria contamination. Waste retains moisture through the growth of vegetation, creating conditions conducive to the proliferation of malaria-carrying mosquitoes (see photos 1 and 2 above). In the city of Koudougou, households in sectors 10, 8 and 6 are close to rubbish dumps. (Figure 4).

According to respondents, approximately 30% of the urban population lives less than 500 metres from a waste dump, even though waste is known to be a prime breeding ground for mosquitoes. This exposes populations to a high
risk of malaria infection (see Table 3 below).
Furthermore, 70% of households live more than
500 metres from an unsanitary area.

<figure><img src="image_10.png" /><figcaption>Figure 4. Proximity of Households to a Waste Dump</figcaption></figure>

<table><caption>Table 3. Proximity to Waste and High Risk of Malaria Infection among City Dwellers</caption><thead><tr><th colspan="3">Less than 500m from waste in the town of Koudougou</th></tr><tr><th>Level of risk of contamination</th><th>Frequency</th><th>Percentage</th></tr></thead><tbody><tr><td>Very high</td><td>260</td><td>70%</td></tr><tr><td>High</td><td>112</td><td>30%</td></tr><tr><td>Total</td><td>372</td><td>100</td></tr></tbody><tbody><tr><th colspan="3">More than 500m from waste in the town of Koudougou</th></tr><tr><th>Level of risk of contamination</th><th>Frequency</th><th>Percentage</th></tr><tr><td>Very low</td><td>50</td><td>13.44%</td></tr><tr><td>Low</td><td>322</td><td>86.56%</td></tr><tr><td>Total</td><td>372</td><td>100</td></tr></tbody></table>

## The presence of water bodies in Koudougou and the high risk of malaria infection

The rainfall situation in Burkina Faso changed between 1980 and 2024 (Rouamba et al., 2023; Yaméogo, 2025a, 2025b). Rainfall is characterised by high variability, accompanied by extreme events (Yaméogo and Rouamba, 2023; Yanogo and Yaméogo, 2023). The study area experienced an increase in extreme rainfall intensities, such as the SDII, over the period 1991-2020 (see Figure 5).

<figure><img src="image_11.png" /><figcaption>Figure 5. Increase in SDII in the city of Koudougou over the period 1991-2020</figcaption></figure>

Source: Saria station, 1991-2020

Figure 5 shows an increase in SDII between 1991 and 2023. This means that the area is experiencing extreme rainfall. This situation leads to a phase of very wet precipitation in the city. The watercourses are therefore permanent. However, the dwellings are close to the water body (see Figure 6).

<figure><img src="image_12.png" /><figcaption>Figure 6. Contiguity of Households in the Water Body of the City of Koudougou</figcaption></figure>

However, proximity to wet areas, such as riverbanks, encourages the proliferation of malaria-carrying mosquitoes and increases the incidence of the disease. In the city of Koudougou, residents of sectors 10, 8 and 6, who live near a watercourse, are affected by malaria during the rainy season, whereas the disease is less common when residents live more
than 500 metres away. Table 4 summarises the perceptions of city dwellers.

<table><caption>**Table 4. Proximity to Water Bodies and Incidence of Malaria among City Dwellers**</caption><thead><tr><th colspan="3">Less than 500m from the water body in the town of Koudougou</th></tr><tr><th>Level of risk of malaria contamination</th><th>Frequency</th><th>Percentage</th></tr></thead><tbody><tr><td>Very high</td><td>292</td><td>78.5</td></tr><tr><td>High</td><td>80</td><td>21.5</td></tr><tr><td>Total</td><td>372</td><td>100</td></tr></tbody><thead><tr><th colspan="3">More than 500m from the water in the town of Koudougou</th></tr><tr><th>Level of risk of malaria contamination</th><th>Frequency</th><th>Percentage</th></tr></thead><tbody><tr><td>Very low</td><td>39</td><td>10.48</td></tr><tr><td>Low</td><td>333</td><td>89.52</td></tr><tr><td>Total</td><td>372</td><td>100</td></tr></tbody></table>

Table 4 shows that the presence or absence of moisture has an impact on the level of malaria contamination. During the winter season, rainfall increases, causing flooding. This causes water to remain in water bodies. This situation encourages mosquito larvae to reproduce, as part of their life cycle takes place in water or on damp surfaces. It is therefore easy for the inhabitants of sectors 6, 8 and 10 of the city of Koudougou to become infected.

## General Sanitation Conditions in the City: A Factor in Mosquito Proliferation

With regard to sanitation in the city, 73% of households consider the city to be moderately clean. 5% consider the city of Koudougou to be clean and 4% consider it to be very clean. On the other hand, 16% of households say that the city is dirty and 2% consider it to be very dirty. The general state of sanitation in a city is a factor that predicts better health for its inhabitants. The decline in the mosquito population may be linked to major sanitation operations such as the construction of drainage networks and the maintenance of gutters. These actions, combined with good household waste

management, can contribute to the definitive elimination of malaria in a relatively short period of time. The unsanitary conditions in the city encourage the hatching of mosquito larvae in breeding sites (Figure 7 below).

<figure><img src="image_13.png" /><figcaption>**Figure 7. Households' Opinions on the State of Sanitation in the City**</figcaption></figure>

Source: Field data, October 2023

Furthermore, latrines are breeding grounds for mosquitoes and promote the transmission of malaria. In the study areas, several uses of latrines were observed (Figure 8).

This figure shows that 0.30% of households defecate in the open, 57.5% use improved latrines, 1.4% use latrines belonging to other households, 14.4% use modern flush toilets, and traditional latrines account for 26.6% of the total number of latrines in the sampled households. Poorly maintained latrines then become a breeding ground for mosquitoes. The fact that 28.3% of the households sampled do not use modern latrines contributes to unsanitary conditions and air pollution in the city. Similarly, a proportion of those surveyed do not have private latrines; these households may therefore be tempted to defecate in the open at the slightest opportunity. It should also be noted that malaria is linked to the state of the immediate and even distant environment.
<figure><img src="image_14.png" /><figcaption>Figure 8. Use of Latrines and Link to the Persistence of Malaria</figcaption></figure>

Source: Field data, October 2023

## Urban Agriculture and Blatant Unsanitary Conditions in Sector 10

Like Sector 6, this sector seems to be the least well served by the city authorities. It is also a traditional neighbourhood home to indigenous inhabitants with rural lifestyles. In this section, the extension of the Issouka dam and market gardening attracted particular attention. All these areas were surveyed thoroughly in order to better identify the environmental factors that favour the hatching of mosquito larvae. The survey extended to open canals and sewers. A home visit allowed us to examine the condition of showers and latrines. We also verified the presence of stables in certain households.

<figure><img src="image_15.png" /><figcaption>Photo 3. Market Gardening in Sector 10
Source: LOSSIANE Karim, September 2023</figcaption></figure>

<figure><img src="image_16.png" /><figcaption>Photo 4. Uncontrolled Landfill
Source: LOSSIANE Karim, September 2023</figcaption></figure>

## The Impact of Environmental Conditions on Malaria Morbidity and Frequency

### Malaria morbidity in the population

When comparing health data with data on the categorised population in the study area, it is clear that the malaria morbidity rate in 2022 and 2023 is high for both groups (population under 5 years of age and population over 5 years of age). Table 4 below shows the health situation in sector 6. In this sector, the percentage of simple malaria cases is still high for both groups. In fact, the percentages of simple malaria are 95.8% and 87.7% for 2022 and 2023 respectively when considering people over 5 years of age. For people under the age of 5, these percentages for 2022 and 2023 are 172% and 136.54% respectively. This morbidity rate indicates that the same patient has been infected with malaria
one or more times during the year. In the case of severe malaria and for the population over 5 years of age, the infection rate is significantly low (1.25% in 2022 and 1.38% in 2023). Health data

show low rates of severe malaria among children under 5 years of age, with 2.25% in 2022 and 1.58% in 2023.

<table><caption>Table 5. Health data and Population Categorised by Sector 6</caption><thead><tr><th>Year</th><th>Malaria cases</th><th>Confirmed cases in sector 6</th><th>Population categorised</th><th>Morbidity rate</th></tr></thead><tbody><tr><td rowspan="4">2022</td><td>Simple malaria (05 years and over)</td><td>11789</td><td>12.306</td><td>95.8 %</td></tr><tr><td>Severe malaria (05 years and over)</td><td>155</td><td>12.306</td><td>1,25 %</td></tr><tr><td>Simple malaria (under 05 years)</td><td>3586</td><td>2.085</td><td>172 %</td></tr><tr><td>Severe malaria (under 05 years)</td><td>47</td><td>2.085</td><td>2.25 %</td></tr><tr><td rowspan="4">2023</td><td>Simple malaria (05 years and over)</td><td>10793</td><td>12.306</td><td>87.70 %</td></tr><tr><td>Severe malaria (05 years and over)</td><td>171</td><td>12.306</td><td>1.38 %</td></tr><tr><td>Simple malaria (under 05 years)</td><td>2847</td><td>2.085</td><td>136.54 %</td></tr><tr><td>Severe malaria (under 05 years)</td><td>33</td><td>2.085</td><td>1.58 %</td></tr></tbody></table>

Sources: data from the Koudougou health district, 2023, and INSD/RGPH, 2019

Referring to Table 5 below, we can see that in Sector 8, the percentages of simple malaria cases are 80.45% and 42.10% for 2022 and 2023 respectively, when considering people over the age of 5. For people under the age of 5, the percentages for 2022 and 2023 are 225.83% and 166.46%. In the case of uncomplicated malaria,

the percentages of the population affected remain high overall. For cases of severe malaria, the rate for those over 5 years of age was 1.2% in 2022 and 1.20% in 2023. For the population under 5 years of age, the infection rate is also low: 3.93% in 2022 and 4.53% in 2023.

<table><caption>Table 6. Health Data and Population Categorised by Sector 8</caption><thead><tr><th>Year</th><th>Malaria cases</th><th>Confirmed cases in sector 8</th><th>Population categorised</th><th>Morbidity rate</th></tr></thead><tbody><tr><td rowspan="4">2022</td><td>Simple malaria (05 years and over)</td><td>8911</td><td>11.077</td><td>80.45 %</td></tr><tr><td>Severe malaria (05 years and over)</td><td>114</td><td>11.077</td><td>1.02 %</td></tr><tr><td>Simple malaria (under 05 years)</td><td>2640</td><td>1.169</td><td>225.83 %</td></tr><tr><td>Severe malaria (under 05 years)</td><td>46</td><td>1.169</td><td>3.93 %</td></tr><tr><td rowspan="4">2023</td><td>Simple malaria (05 years and over)</td><td>4663</td><td>11.077</td><td>42.10 %</td></tr><tr><td>Severe malaria (05 years and over)</td><td>133</td><td>11.077</td><td>1.20 %</td></tr><tr><td>Simple malaria (under 05 years)</td><td>1946</td><td>1.169</td><td>166.46 %</td></tr><tr><td>Severe malaria (under 05 years)</td><td>53</td><td>1.169</td><td>4.53 %</td></tr></tbody></table>

Sources: health data from the Koudougou health district, 2023, and INSD/RGPH, 2019

Health data for sector 10 are presented in Table 6 below. The percentages of simple malaria cases are 38.56% and 34.34% for 2022 and 2023, respectively, for people over the age of 5. For people under the age of 5, the percentages for 2022 and 2023 are 78.81% and 50.01%. For

cases of severe malaria, the figures for people over the age of 5 were 1.29% in 2022 and 0.72% in 2023. For the population under the age of 5, the infection rate is 2.11% in 2022 and 1.71% in 2023.

<table><caption>Table 7. Health Data and Population Categorised by Sector 10</caption><thead><tr><th>Year</th><th>Malaria cases</th><th>Confirmed cases in sector 10</th><th>Population categorised</th><th>Morbidity rate</th></tr></thead><tbody><tr><td rowspan="2">2022</td><td>Simple malaria (05 years and over)</td><td>6179</td><td>16.022</td><td>38.56 %</td></tr><tr><td>Severe malaria (05 years and over)</td><td>207</td><td>16.022</td><td>1.29 %</td></tr></tbody></table>
<table><tr><td></td><td>Simple malaria (under 05 years)</td><td>2017</td><td>2.559</td><td>78.81%</td></tr><tr><td></td><td>Severe malaria (under 05 years)</td><td>54</td><td>2.559</td><td>2.11%</td></tr><tr><td rowspan="4">2023</td><td>Simple malaria (05 years and over)</td><td>5502</td><td>16.022</td><td>34.34%</td></tr><tr><td>Severe malaria (05 years and over)</td><td>116</td><td>16.022</td><td>0.72%</td></tr><tr><td>Simple malaria (under 05 years)</td><td>1280</td><td>2.559</td><td>50.01%</td></tr><tr><td>Severe malaria (under 05 years)</td><td>44</td><td>2.559</td><td>1.71%</td></tr></table>

Sources: health data from the Koudougou health district, 2023, and INSD/RGPH, 2019

## Frequency of malaria cases in 2023

Data from field surveys also indicate that, during 2023, most households that responded to the questionnaire estimated that they had been affected by malaria at least once and three times per year. This indicates that the malaria

morbidity rate is very high within the sample and reflects the persistence and endemicity of this disease in the three study areas. However, some households in the sample reported not having contracted malaria during the same period. These disproportionate figures for the three areas are shown in the figure below.

<figure><img src="image_17.png" /><figcaption>Figure 9. Frequency of Disease Recurrence</figcaption></figure>

Source: field data, October 2023

## Discussion

Following field surveys, it appears that the risk of malaria is very real in Koudougou. The persistence of the disease is linked to socio-environmental factors such as poor waste management, the discharge of stagnant water and failure to comply with sanitary measures. In our study site, 71% of households live near a body of water: Fane,(2011) estimates that without water, the mosquito's cycle would be interrupted. Water is therefore essential to the mosquito's development cycle. Malaria is also

highly endemic during the winter months, as confirmed by the respondents. For the authors, Carnevale et al.(2004), and Zango,(2022), the state of the environment is a key factor in the transmission of malaria. Sabatinelli et al.,(1986) go even further, estimating that 23% of malaria-related deaths recorded worldwide are attributable to environmental factors. According to Tomasi & Vanny (2016,p. 156), there is therefore "a relationship between morbidity per household and the quality of buildings".

Other studies, conducted by Gu et al. 2006), have shown that the higher the number of
Anopheles breeding sites in an environment, the greater the density of these mosquitoes. Sy et al.(2016) believe that environmental factors must be taken into account in the fight against malaria. According to Carnevale et al. (2004), agricultural developments can lead to a sharp increase in Anopheles density. All these authors confirm the results of the surveys. According to Yaméogo's (2022) studies on the city of Koudougou, 81% of households surveyed reported having had malaria two or three times, and 70% of them find the urban environment of Koudougou very dirty. Bouma & Rowland (1995) and Seyoum et al.(2002) reported that the presence of domestic animals in households increased the rate of malaria infection in humans. Health statistics show that malaria is unevenly distributed in the city's urban environment. According to the 2012 SDAU, the marshland area of sector 8 covers 48164 m² and the market garden area of sector 10 covers 159,466 m². This situation makes the city of Koudougou conducive to the proliferation of mosquitoes. This exposes the populations of the city of Koudougou to malaria during the rainy season.

## Conclusion

Malaria remains a serious public health problem today. Its impact on human societies is considerable. The persistence and prevalence of this disease in the urban environment of Koudougou is largely linked to the relationship between humans and their environment. A defective sanitation system combined with social factors compromises malaria control strategies. Our study shows that the persistence of malaria is linked to environmental degradation and the behaviour of the city's inhabitants. In reality, malaria control strategies operate on two levels: vector control and control of Plasmodium, the parasite responsible for the disease. The fight against malaria should also take into account urban sanitation and changes in people's lifestyles. Without this, it will be difficult to overcome an environmental disease such as malaria, as Plasmodium has very quickly developed resistant strains.

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