Background Every 75 seconds, a child under five dies of malaria. Mainly children, aged between six months and five years, are at the highest risk for malaria. These children lost maternal immunity and did not yet developed specific immunity to the infection. Under the age of five, children bear the highest burden of malaria in Sub-Saharan Africa (SSA). Many individual and community level factors could contribute to malaria prevalence remaining high among under-five children in the region. Thus, this study aimed to assess the pooled prevalence of malaria among children aged 6–59 months and identify potential factors associated with malaria by using recent Malaria Indicator Surveys in 13 SSA countries. Methods Data for this study were drawn from recent 13 Sub-Saharan African countries Malaria Indicator Surveys (MIS). A total weighted sample of 60,541 children aged 6–59 months was included. STATA version 14.2 was used to clean, code and analyze the data. Multilevel logistic regression was employed to identify factors associated with malaria. Adjusted odds ratio with 95% CI and a P value <0.05 was reported to indicate statistical association. Model fitness and comparison were done using Inter cluster correlation coefficient, Median odds ratio, proportional change in variance, and deviance. Results The pooled prevalence of malaria among children aged 6–59 months was found to be 27.41% (95% CI: 17.94%-36.88%). It ranges from 5.04% in Senegal to 62.57% in Sierra Leone. Aged 36–47 months (AOR = 3.54, 95% CI 3.21–3.91), and 48–59 months (AOR = 4.32, 95% CI 3.91–4.77), mothers attended primary education (AOR = 0.78, 95% CI 0.73–0.84), richer (AOR = 0.35, 95% CI 0.32–0.39), and richest household (AOR = 0.16, 95% CI 0.14–0.19), number of three and more under-five children (AOR = 1.35, 95% CI 1.26–1.45), improved floor material (AOR = 0.65, 95% CI 0.57–0.73), improved wall material (AOR = 0.73, 95% CI 0.64–0.84), improved roof material (AOR = 0.70, 95% CI 0.51–0.93), insecticide-treated bed net (ITN) use (0.56, 95% CI 0.51–0.62), not anemic (AOR = 0.05, 95% CI 0.04–0.06), rural resident (AOR = 2.16, 95% CI 2.06–2.27), high community ITN use (AOR = 0.40, 95% CI 0.24–0.63) and high community poverty (AOR = 2.66, 95% CI 2.53–2.84) were strongly associated with malaria. Conclusions and recommendations Almost 3 out of 10 children were infected by malaria in 13 SSA countries. Malaria infection remains one of the main killers of children aged 6–59 months in the SSA. This study revealed that older under-five children living in large families with low incomes in rural areas are most vulnerable to malaria infection. Our results clearly indicate that ITN utilization and improved housing are promising means to effectively prevent malaria infection among children aged 6–59 months. It is therefore important to note that households with low wealth quintiles and rural residents should be prioritized in any mass distribution of ITNs. This has to be accompanied by education using mass media to enhance community awareness.

Background: In most developing countries, childhood illness and deaths are among the most challenging health issues. Most of these deaths were due to preventable causes including acute respiratory infections (ARI), diarrhea, and febrile illnesses. Thus, identification of determinants of childhood illness would help to guide strategic planning and prioritize interventions.Method: Community based cross-sectional study was conducted. A two-stage cluster sampling technique was used to select households and mothers/caregivers. A total of 2,158 mothers with at least one under-five child were included. Mothers were interviewed at their homes using structured questionnaire. Adjusted Odds Ratio with a 95% Confidence Interval and P-value <0.05 in the multivariable model were reported to show the significance and direction of association.Result: The overall prevalence of childhood illnesses was 16.5% (95% CI: 15.0, 18.2). Of all, 6.5% (95% CI: 5.5, 6.72), 7.5% (95% CI: 6.5, 8.76), and 12.0% (95% CI: 10.66, 13.40) had diarrhea, ARI, and fever, respectively. The treatment-seeking behavior of mothers/care-givers for any of the childhood illness was 22.7% (18.72, 27.42). The odds of childhood illness was higher among mothers’ age 15-19 years (AOR=2.87-; 95% CI: 1.33, 6.13), employed mothers’ (AOR=2.28; 95%CI: 1.84, 4.39), living far away from nearest health center (AOR=1.02; 95%CI: 1.01, 1.03), two under-five children (AOR=1.33;95%CI: 1.029,1.74) and three or more children in the house (AOR=2.70; 95%CI: 1.12, 6.53). About 22.8% (95% CI: 18.7, 27.4) of mothers/caregivers sought health care. Mothers’ occupation (AOR= 4.08 (95% CI: 1.35, 12.39) was the only independent predictor of treatment-seeking behavior.Conclusion: In this study, common childhood illnesses remain high while the treatment-seeking behavior of the mothers’/caregivers’ was low. Mothers’ age, occupation, distance from the nearest health center, and two or more children in the house were independent factors of childhood illness. Being a skilled/semi-skilled mothers was significantly associated with health-seeking behavior of mothers/caregivers. Thus, involving women in skilled/semi-skilled occupations would help in decreasing childhood illness and enhance health-seeking behaviors for their under-five children. Besides, providing access to health care facilities in their nearby area would be essential in reducing childhood illness.

Background: In most developing countries, childhood illness and deaths are among the most challenging health issues. Most of these deaths were due to preventable causes including acute respiratory infections (ARI), diarrhea, and febrile illnesses. Thus, the identification of determinants of this childhood illness would help to guide strategic planning and prioritize interventions.Method: Community based cross-sectional study was conducted. A two-stage cluster sampling technique was used to select households and mothers/caregivers. A total of 2,158 mothers with at least one under-five child were included. Mothers were interviewed at their homes using structured questionnaire. Adjusted Odds Ratio with a 95% Confidence Interval for variables with P-value <0.05 in the multivariable model were reported to show the significance and the direction of association.Result: The overall prevalence of childhood illnesses was 16.5% (95% CI: 15.0, 18.2). Of all, 6.5% (95% CI: 5.5, 6.72), 7.5% (95% CI: 6.5, 8.76), and 12.0% (95% CI: 10.66, 13.40) had diarrhea, ARI, and fever, respectively. The treatment-seeking behavior of mothers/care-givers for any of the childhood illness was 22.7% (18.72, 27.42). The odds of childhood illness was higher among mothers’ age 15-19 years (AOR=2.87-; 95% CI: 1.33, 6.13), employed mothers’ (AOR=2.28; 95%CI: 1.84, 4.39), living far away from nearest health center (AOR=1.02; 95%CI: 1.01, 1.03), two under-five children (AOR=1.33;95%CI: 1.029,1.74) and three or more children in the house (AOR=2.70; 95%CI: 1.12, 6.53). About 22.8% (95% CI: 18.7, 27.4) of mothers/caregivers sought health care. Mothers’ occupation (AOR= 4.08 (95% CI: 1.35, 12.39) was the only independent predictor of treatment-seeking behavior.Conclusion: In this study, common childhood illnesses remain high while the treatment-seeking behavior of the mothers’/caregivers’ was low. Mothers’ age, occupation, distance from the nearest health center, and two or more children in the house were independent factors of childhood illness. Being a skilled/semi-skilled mothers was significantly associated with health-seeking behavior of mothers/caregivers. Thus, involving women in skilled/semi-skilled occupations would help in decreasing childhood illness and enhance health-seeking behaviors for their under-five children. Besides, providing access to health care facilities in their nearby area would be essential in reducing childhood illness.

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