Family bio-social variables associated with severe malaria disease among under-five children in resource-poor setting of a rural hospital in Eastern Nigeria

Abstract

Background: Malaria threatens the lives of under-five in rural Nigerian families. Although factors that influence malaria in under-five are manifold, family bio-social factors may contribute to the variability of the clinical picture. Aim: To determine family bio-social variables associated with severe malaria among under-five children in a resource-poor setting of a rural hospital in Eastern Nigeria. Materials and Methods: A cross-sectional study was carried out on the families of under-five managed for malaria. Data extracted included family bio-social variables and diagnosis. An under-five child was defined to have malaria if the mother gave complaints of fever, vomiting and other symptoms suggestive of malaria, had body temperature exceeding 37.5΀C with the asexual forms of Plasmodium falciparum detected on the peripheral blood film. Severe malaria is the malaria that presents with life-threatening features like severe anemia and cerebral malaria. Results: The prevalence of severe malaria was 31.8%. The family bio-social variables significantly associated with severe malaria were maternal low level of education (P = 0.031), family size >4 (P = 0.044), low social class of the family (P = 0.025), non-living together of parents (P = 0.011), and poor access to health facilities (P = 0.038). The most significant predictor of severe malaria was non-living together of parents (P = 0.000, OR = 3.08, CI = 1.64-5.10). Conclusion: This study has demonstrated that some family bio-social variables are associated with severe malaria. These families should constitute at risk families that could be targeted for malaria interventional programs.