Factors Associated with Malaria Prevalence among Children under Five Years in the Hohoe Municipality of Ghana

Abstract

Background: Malaria continues to adversely impact the health of children in Ghana. Hohoe is an area of intense and prolonged, seasonal malaria transmission and malaria is still the leading cause of morbidity and mortality among children under five years. This study was set out to determine factors associated with malaria infection among children less than five years. Method: An unmatched case-control study was conducted in November 2015 involving children less than five years from 30 communities. Information on the background characteristics of the children and parents/guardians were collected using a pretested questionnaire. Children were screened to determine their malaria infection status using finger prick blood for RDT. Anthropometric indices and axillary temperature were measured, as well as blood film for malaria parasites and haemoglobin levels. T-test was used for means and Odds Ratios was used to determine the relationships and associations between the dependent and independent variables. Results: Out of 1697 children screened, 676 (39.8%) tested positive with RDT (cases) and 1,021 tested negative (controls). Older children aged 24-35 and 36-47, and 48 months and above were more likely to have malaria as compared to the younger age group 6-11 months (OR=1.66 (95% CI: 1.04-2.65); p=0.034), (OR=1.77 (95% CI: 1.10-2.87); p=0.019) and (OR=2.02 (95% CI: 1.24-3.29); p=0.005), respectively. Current fever, History of fever within one week and antimalarial drug use at home were 3.07, 1.75 and 4.03 times more likely to occur among cases than in the controls (OR=3.07 (95% CI: 1.21-7.81); p<0.018), (OR=1.75 (95% CI: 1.29-2.37); p<0.001) and (OR=4.03 (95% CI: 2.82-5.77); p<0.001), respectively. Anaemia (HB<11.0g/dL) was 1.87 times more likely among the cases than in the controls (OR=1.87 (95% CI: 1.40-2.48); p<0.001). Children of parents/guardians who were farmers and traders were more likely to have malaria (OR=1.73 (95% CI: 1.16-2.56); p=0.007) and (OR=1.83 (95% CI: 1.22-2.74); p=0.003), respectively. Conclusion: Age, current fever, history of fever within one week, anaemia, use of antimalarial drugs at home and parent/guardian’s occupation were factors associated with malaria infection. Targeted screening and treatment of older children and intensive education on malaria prevention in addition to the current control activities could serve as tools for controlling malaria to the level of elimination.