Multilevel modelling of malaria risk in children under five years old in Nigeria

Abstract

Background:Malaria remains a major public health threat in sub-Saharan Africa. Despite efforts to eradicate the disease in Nigeria, it is still a major cause of morbidity and mortality; especially among children under five (U5) years. This study assessed individual, household, and community risk factors for malaria in Nigerian children U5 years of age.Methods:Data from the Nigerian Malaria Health Indicator Survey 2015 were pooled for analyses. This comprised of national survey of 329 clusters. Children aged 6-59 months who were tested for malaria using microscopy were retained. Multilevel logit model accounting for sampling design was used to assess individual, household and community factors associated with malaria parasitaemia. Results:A total of 5742 children were assessed for malaria parasitaemia with overall prevalence of 27% (95% CI 26-28%). Plasmodium falciparum constituted 98% of the Plasmodium species. There was no significant difference in parasitaemia between older children, and those ≤12 months. In adjusted analyses, rural living, Northwest region, household size of >7, dependence on river and rain water as primary water source were associated with higher odds of parasitaemia; while higher wealth index, all U5s who slept under bed net and dependence on packaged water were associated with lower odds of parasitemia.Conclusion:Malaria remains a substantial public health burden in Nigeria, especially in U5 children, despite sustained investment in malaria control and prevention. A quarter of the overall national burden are in the U5s. Across the six geopolitical zones, the highest burden was in children living in poorest rural households.

Malaria Temporal Variation and Modelling Using Time-Series in Sussundenga District, Mozambique

“…This study nds a spatial variation of malaria cases between administrative wards. Similar results were reported in Mozambique [23,28,32] in Africa [33,34] and other parts of the World [35,36]. This study nds a decreasing tendency of malaria cases for age category 0 to 4 years.…”