Rice fields in Africa are major breeding sites for malaria vectors. However, when reviewed in the 1990s, in settings where transmission was relatively intense, there was no tendency for malaria indices to be higher in villages with irrigated rice fields than in those without. Subsequently, intervention coverage in sub-Saharan Africa has been massively scaled up and malaria infection prevalence has halved. We re-examined this rice–malaria relationship to assess whether, with lower malaria transmission, malaria risk is greater in rice-growing than in non-rice-growing areas.

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