Malaria among under-five children in Ethiopia: a systematic review and meta-analysis

Abstract

Background Globally, malaria is among the leading cause of under-five mortality and morbidity. Despite various malaria elimination strategies being implemented in the last decades, malaria remains a major public health concern, particularly in tropical and sub-tropical regions. Furthermore, there have been limited and inconclusive studies in Ethiopia to generate information for action towards malaria in under-five children. Additionally, there is a considerable disparity between the results of the existing studies. Therefore, the pooled estimate from this study will provide a more conclusive result to take evidence-based interventional measures against under-five malaria. Methods The protocol of this review is registered at PROSPERO with registration number CRD42020157886. All appropriate databases and grey literature were searched to find relevant articles. Studies reporting the prevalence or risk factors of malaria among under-five children were included. The quality of each study was assessed using the Newcastle–Ottawa Quality Assessment Scale (NOS). Data was extracted using Microsoft Excel 2016 and analysis was done using STATA 16.0 statistical software. The pooled prevalence and its associated factors of malaria were determined using a random effect model. Heterogeneity between studies was assessed using the Cochrane Q-test statistics and I2 test. Furthermore, publication bias was checked by the visual inspection of the funnel plot and using Egger’s and Begg’s statistical tests. Results Twelve studies with 34,842 under-five children were included. The pooled prevalence of under-five malaria was 22.03% (95% CI 12.25%, 31.80%). Lack of insecticide-treated mosquito net utilization (AOR: 5.67, 95% CI 3.6, 7.74), poor knowledge of child caretakers towards malaria transmission (AOR: 2.79, 95% CI 1.70, 3.89), and living near mosquito breeding sites (AOR: 5.05, 95% CI 2.92, 7.19) were risk factors of under-five malaria. Conclusion More than one in five children aged under five years were infected with malaria. This suggests the rate of under-five malaria is far off the 2030 national malaria elimination programme of Ethiopia. The Government should strengthen malaria control strategies such as disseminating insecticide-treated mosquito nets (ITNs), advocating the utilization of ITNs, and raising community awareness regarding malaria transmission.

Prevalence of Malaria and Associated Factors during the Minor Malaria Season among Febrile Under-Five Children Attending Mohammed Akile Memorial General Hospital

“…where N is the required sample size, Z is a standardized normal deviation value that corresponds to the level of statistical significance equal to 1.96, P is the estimate of the prevalence of malaria in children under 5 years of age in Afar region, Ethiopia which is 64% [ 11 ], D = is the error margin that corresponds to the level of precision of the results desired ( α = 0.05) N = ((1.96) 2 0.64(1 − 0.64))/((0.05) 2 ) = 354 + 10%(non-response rate, to compensate mothers or guardians possibly missed from an interview) = 389.…”

“…The Afar Region is Ethiopia's most lowland and malarious region, where the majority of its population is at risk of infection, particularly under-five children and pregnant women. Furthermore, according to the 2016 Ethiopian Demographic and Health Survey (EDHS) report, the region has the highest mortality rate among children under five years of age compared to other regions (81 deaths per 1000 live births) [ 11 ]. Studies also showed that more than one in five children under five years of age were infected with malaria [ 12 ].…”

Plasmodium Falciparum neonatal malaria with atypical presentation: A case series from southwestern Ethiopia

“…Ethiopia accounts for 2.1% of the total cases and 1.7% of the Deaths globally [2]. The estimated prevalence of malaria in under-ve children is around 22.03% [4]. Approximately 60% of the Ethiopian population lives in malaria-risky areas [5,6].…”

Prediction of malaria positivity using patients’ demographic and environmental features and clinical symptoms to complement parasitological confirmation before treatment

“…In addition to the Federal Ministry of Health's National Malaria Elimination Programme (NMEP), the President established the "Nigeria End Malaria Council" in August 2022 to reduce the malaria burden in the country and serve as a platform to solicit funds to promote malaria elimination (15); (3); ( 16); (17). Several control measures, including the distribution of long-lasting insecticide-treated mosquito nets, provision of malaria chemoprevention drugs, and utilisation of indoor residual insecticide spray, among other strategies to eradicate malaria, have been implemented by various African governments (18); ( 19); (20); (21); (22). However, despite ongoing efforts by African governments to combat malaria, it remains a signi cant public health challenge in Africa and continues to affect the continent's population and economy (23).…”