Social determinants of malaria prevalence among children under five years: A cross-sectional analysis of Akure, Nigeria

Abstract

The global fight towards the reduction of malaria burden in the last decade has indeed attained great strides. Conversely, and in recent times, the African region especially Nigeria is characterised with increasing malaria burden. With focus on childhood malaria, this paper explores the impact of social determinants of health on malaria occurrence among children under the age of five years old (U5) in emerging city of Akure. Retrospective survey was conducted from October to December 2019 with the aid of pretested Malaria Indicator Questionnaire (MIQ). First, bivariate analysis (Chi-square) was employed to identify and select predictor variables associated with U5 malaria occurrence. Second, social model of malaria was developed engaging the multivariable logistic regression method to model the risk of U5 malaria in Akure. The U5 malaria occurrence was significantly influenced by window protection and netting [Adjusted odds ratios (aOR): 2.44, 95%CI: 0.32 – 1.51, p < 0.01]; distance to waste disposal sites (aOR = 2.11, 95%CI: 0.21 – 1.32, p < 0.01); usage of insecticides treated nets — ITNs (aOR = 3.09, 95%CI: 0.67 – 1.59, p < 0.01); and availability of health infrastructures (aOR: 1.84, 95%CI: 0.13 – 1.10, p < 0.05). The study demonstrated that factors outside the healthcare sector are important drivers of U5 malaria in Akure. As a result, U5 children with frequent usage of ITN, protected window and residents more than 10 metres away to waste disposal sites are less likely to suffer from malaria blight. This paper recommends that interventions should be directed towards the significant predictors as part of malaria reduction strategies in Akure.