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The survey was carried out from August to October, 2011. In total, 4,811 households were sampled. Households were selected using a two-stage process of randomization and a snowball sampling method. First, Dar es Salaam was divided into three main districts (Kinondoni, Ilala and Temeke), then households were selected randomly in each district using a skip interval of 10 households.
The study was designed to provide two public health responses: (1) prediction of individual household consumption levels; and (2) prediction of the prevalence of malaria. The first response is relevant to the use of household consumption data as a proxy for health expenditures and the associated impact on household health expenditures. The second response is relevant to the use of malaria prevalence as a proxy for the impact of malaria interventions on the health of the community. The study involved a cross-sectional survey of households in three districts of Dar es Salaam.
The City of Dar es Salaam, formerly known as Tabora, is divided into three districts (Ilala, Kinondoni and Temeke), each composed of several wards, which are further divided into neighbourhoods (or segments) . The study area was composed of three wards from each district (Fig 1). The distance between each ward is approximately 1.5 km. The households in the study area are also divided into segments (or neighbourhoods). These segments are of various sizes, but large segment is a segment for a small neighbourhood (mis large street). The length of each segment is greater than 4 km.
Ten percent of the collected mosquitoes were randomly selected and transported to the Public Health Laboratory in Dar es Salaam for further testing. These mosquitoes were frozen at -20°C. Titers of ZIKV and CHIKV were determined by plaque-forming assay on Vero cells [16, 17]. Samples with ZIKV and CHIKV titers ≤ 10 were considered negative and were tested for dengue virus (DENV) using the capture ELISA method, as previously described .
Data was collected in three districts: Kinondoni, Ilala and Temeke. The former two districts are located in the western part of Dar es Salaam. Kinondoni District is a low-lying coastal region with an estimated population of 467,943 (Ilala = 226,341; Temeke = 240,601), while Ilala District is located in the central part of Dar es Salaam. It is a densely populated area with an estimated population of 1,218,261 (Ilala = 574,961; Temeke = 643,200). The district has a population density of 2,275 people per square kilometre, while the highest population density is in Ilala City, which is the second most populous City in Tanzania. The Temeke District is located north of Dar es Salaam, with an estimated population of 512,427 (Ilala = 299,653; Kinondoni = 207,764) . These three districts cover an area of 733 km2. The district boundaries do not correspond to the City boundaries. 827ec27edc