Determinants of malaria among under-five children in Ethiopia: Bayesian multilevel analysis

Abstract

Background In Ethiopia, malaria is one of the public health problems, and it is still among the ten top leading causes of morbidity and mortality among under-five children. However, the studies conducted in the country have been inconclusive and inconsistent. Thus, this study aimed to assess factors associated with malaria among under-five children in Ethiopia. Methods We retrieved secondary data from the malaria indicator survey data collected from September 30 to December 10, 2015, in Ethiopia. A total of 8301 under-five-year-old children who had microscopy test results were included in the study. Bayesian multilevel logistic regression models were fitted and Markov chain Monte Carlo simulation was used to estimate the model parameters using Gibbs sampling. Adjusted Odd Ratio with 95% credible interval in the multivariable model was used to select variables that have a significant association with malaria. Results In this study, sleeping under the insecticide-treated bed nets during bed time (ITN) [AOR 0.58,95% CI, 0.31–0.97)], having 2 and more ITN for the household [AOR 0.43, (95% CI, 0.17–0.88)], have radio [AOR 0.41, (95% CI, 0.19–0.78)], have television [AOR 0.19, (95% CI, 0.01–0.89)] and altitude [AOR 0.05, (95% CI, 0.01–0.13)] were the predictors of malaria among under-five children. Conclusions The study revealed that sleeping under ITN, having two and more ITN for the household, altitude, availability of radio, and television were the predictors of malaria among under-five children in Ethiopia. Thus, the government should strengthen the availability and utilization of ITN to halt under-five mortality due to malaria.

A Scoping Review of Selected Studies on Predictor Variables Associated with the Malaria Status among Children under Five Years in Sub-Saharan Africa

“…In 2015, over 214 million estimated cases of malaria were reported, with over 450,000 deaths worldwide [ 2 , 3 ]. Surprisingly, in 2018, the number of malaria cases had risen to over 300 million worldwide [ 4 ], and in 2019 the estimated malaria cases from 87 endemic nations were approximately 230 million [ 3 ]. It is on record that the world experienced a steady decline in the estimated number of deaths from malaria cases from over 730,000 in 2000 to over 400,000 in 2019 [ 3 , 5 ].…”

“…By 2019, under five years, deaths from malaria were over 60% of the total estimated deaths [ 3 ]. It is worth noting that in the last two decades, many programs and strategies have been implemented to control malaria both at the global and country levels, which has resulted in the prevention of over 6 million deaths between 2000 and 2015 in SSA [ 4 ].…”

“…In Tanzania, malaria is responsible for more than 10% of under-five deaths and is the second largest contributor to childhood morbidity and mortality [ 7 ] and is the leading cause of death in Mozambique, accounting for over 30% of all deaths [ 8 ]. Ethiopia, on the other hand, is recorded amongst the countries with the highest under-five mortality in SSA [ 9 ], with almost a quarter of the country being malaria-endemic, such that a greater proportion are exposed to malarial infection [ 4 ]. In 2016, Cameroon contributed about 3% of the total number of global deaths from malaria-related cases, and most of these deaths are among under-five-year-old children [ 10 ].…”

“…Researchers have attributed the prevalence of malaria in SSA to several factors, which include medical conditions, environmental factors/seasonal influences and human status (such as age, gender, pregnancy, blood group and rhesus factors, among others), socioeconomic, demographic and area-related characteristics [ 4 , 17 ]. Malaria infection is said to be more prevalent in rural areas than in urban centers [ 14 ].…”

A Scoping Review of Selected Studies on Risk Factors Associated with the Malaria Status among Children Under-five Years in Sub-Sahara Africa

“…In 2015, over 214 million estimated cases of malaria were reported with over 450,000 deaths worldwide [2,3]. Surprisingly, in 2018, the number of malaria cases has risen to over 300 million worldwide [4], and in 2019 the estimated malaria cases from 87 endemic nations were approximately 230 million [3]. It is on record that the world experienced steady decline in the number of deaths from malaria cases from over 730,000 in 2000 to over 400,000 in 2019 [3,5].…”