Prevalence and Associated Factors of Malaria among Febrile Children in Afar Region, Ethiopia A Health Facility Based Study

Abstract

BACKGROUND: Malaria is a major public health problem in Sub-Saharan Africa including Ethiopia and it affects children under five andpregnant mothers. Theprevalence of malaria is not well studied though theburden is expected to be high in low lands of Afar region.Therefore,thisstudy attempts to assess the prevalence and associated factors of malariaamong under five children in the pastoral community.METHODS: Cross-sectional study design was employed from April 15 th to15 th May 2018 on a sample of 484 under-five children who visited therandomly selected health facilities of Dubti district, Afar region.The studyparticipants were recruited randomly with the basic assumption that theirarrival at health facilities is random. The main outcome variable wasparasitological confirmed malaria among under five children and it wasmeasured using either microscopy blood film examination. Binary logisticregression model was done to measure the association between confirmedmalaria infection and its predictors. Independent variables with p-valueless than 0.25 in the bivariate analysis were entered into multivariablelogistic regression analysis model. Statistical significance level wasdeclared at p-value less than 0.05.RESULTS: The prevalence of malaria among febrile under-five childrenwas 64% (95% CI 59.5%-68.4%). Of these,more than half (66.5%) andone-fifth (22. 2%) of the cases were caused by p.falciparum and p.vivaxrespectively. The multivariable logistic regression analysis showedthatliving in rural residence [AOR=1.77: 95% CI 1.10-2.85], havingeducated mother [AOR=0.406: 95% CI 0.26-0.63], age of child([AOR=2.98: 95% CI 1.41-6.32], sex of child [AOR=1.99: 95% CI 1.29-3.08], not sleep under ITN [AOR=9.10: 95% CI 1.01- 82.58], ITNavailability [AOR=2.23: 95% CI 1.01- 4.89] and history of malariainfection among family members [AOR=9.10: 95% CI 1.01-82.58] werethe independent predictors of malaria infection among under fivechildren.CONCLUSION: The overall prevalence of malaria among under-fivechildren was high compared to the national prevalence of malaria amongthe general population. Health care providers (HCPs) should educateparents/guardians regarding proper utilization of ITN at night. Inaddiotion, they should provide early treatment for febrile family membersto halt the transmission of malaria. The regional government should givedue attention to supply of ITN and enhance the awareness of thecommunity. Additional longitudinal studies are recommended.