Demographic and epidemic transitions in peri-urban areas of Colombia: a multilevel study of malaria in the Amazonian city of San José del Guaviare

Migration to urban centres is among the most important forces in contemporary urban studies. In this paper, we study how the demography and epidemic profile of a community are altered when they transition from living in nomadic conditions in a forested environment to a peri-urban settlement in a city of the Amazon basin. We analyse demographic and epidemic data with a multilevel model to understand individual and community-level effects in terms of the risk of malarial infection. We show that malaria becomes endemic when the population settles in the peri-urban area of the city. We also show that the reproductive rate of women in the group increases as they become sedentary, and that while individual fertility rates have no effect on risk of contracting malaria, population-level fertility rates are associated with malaria endemicity.