Sociodemographic factors associated with malaria parasitaemia among under-fives in Nigeria: Evidence from National Malaria Indicator Survey (NMIS), 2015

Abstract

Background: Malaria among under-fives (U5) remains a priority issue that calls for global public health attention. Although much have been achieved in the past decade, there is still need to continuously review and monitor progress. The aim of this study was to determine the socio-demographic factors associated with malaria parasitaemia in children less than 5 years in Nigeria. Methods & Materials: A secondary data analysis of the Nigeria Malaria Indicator Survey, 2015 was carried out. Data were extracted for U5 children tested for parasitaemia using Microscopy and Rapid Diagnostic Tests (RDT). Parasitaemia status was main outcome. Independent variables considered include child's age, gender, residence, region, household wealth index, household size, gender of household head and use of ITN night before the survey. Data was analysed using descriptive statistics, chi-square and binary logistic regression at p < 0.05. Results: A total of 6,050 U5 children were tested for malaria. Their mean age was 32.9 ± 15.5 months. All had RDT results analysed, but microscopy data for 285 (4.7%) children were not available. Overall prevalence of parasitaemia using microscopy and RDT tests were 27.3% (95% CI; 24.6 -30.2) and 45.1% (95% CI; 41.7 – 48.5) respectively. There was a significant association between age and prevalence rate (χ2 = 21.477, p < 0.001). For both tests, prevalence decreased with increasing household wealth index (χ2 = 16.9, p = 0.002). Children from South-East region had least prevalence (4.4% and 6%, Microscopy and RDT respectively) while highest prevalence (43.3% and 41.7% for microscopy and RDT) was from the North-West region. Higher household size (≥ 7 members) was also significantly associated with higher prevalence for microscopy (χ2 = 12.04, p < 0.001), as well as RDT results (χ2 = 19.54, p < 0.001). Children residing in the rural areas were about 1.65 time more likely to have parasitaemia compared to those from the urban areas (OR: 1.6; 95% CI: 1.17 – 2.33). Conclusion: Child's age, residence, region and household wealth index, are key factors influencing burden of malaria among under-fives in Nigeria. Continuous education of caregivers, as well as control strategies designed to equitably allocate resources to most vulnerable populations are advocated.