Prevalence Of Malaria In Children Research Articles

Correlation Of Malnutrition Status With Malaria Incidents In Children Under 5 Years Old

Malaria is a prevalent disease that continues to affect infants and results in the death of over 435,000 individuals worldwide, with children under the age of five accounting for 11-30% of these fatalities. Malnutrition afflicts millions of children worldwide, especially in Indonesia, and is the leading cause of mortality among toddlers. Investigate the correlation between malnutrition and the occurrence of malaria in children under the age of five. Additionally, explore the prevalence, factors that contribute to the risk, and underlying processes of both malaria and malnutrition. This study utilized 15 internationally recognized scholarly articles to investigate the correlation between malnutrition and the prevalence of malaria in children below the age of five. According to the analysis of 10 scholarly studies, the occurrence of malaria and malnutrition among children under the age of five remains significantly elevated, particularly in African nations, various countries in South Asia, Southeast Asia, the Middle East, Central America, and South America. The analysis of 3 journal papers examined the risk factors associated with malaria and malnutrition, specifically focusing on age, environment, sanitation, economy, education, food availability, and residing in refugee camps. After reviewing 9 journal publications, it has been shown that malnutrition is a risk factor for malaria. Additionally, one of the articles suggests that children who are malnourished have a reduced likelihood of contracting malaria. The findings of this scoping review indicate a bidirectional correlation between malnutrition and the occurrence of malaria in young children.

Bayesian spatio-temporal analysis of malaria prevalence in children between 2 and 10 years of age in Gabon

BackgroundGabon still bears significant malaria burden despite numerous efforts. To reduce this burden, policy-makers need strategies to design effective interventions. Besides, malaria distribution is well known to be related to the meteorological conditions. In Gabon, there is limited knowledge of the spatio-temporal effect or the environmental factors on this distribution. This study aimed to investigate on the spatio-temporal effects and environmental factors on the distribution of malaria prevalence among children 2–10 years of age in Gabon.MethodsThe study used cross-sectional data from the Demographic Health Survey (DHS) carried out in 2000, 2005, 2010, and 2015. The malaria prevalence was obtained by considering the weighting scheme and using the space–time smoothing model. Spatial autocorrelation was inferred using the Moran’s I index, and hotspots were identified with the local statistic Getis-Ord General Gi. For the effect of covariates on the prevalence, several spatial methods implemented in the Integrated Nested Laplace Approximation (INLA) approach using Stochastic Partial Differential Equations (SPDE) were compared.ResultsThe study considered 336 clusters, with 153 (46%) in rural and 183 (54%) in urban areas. The prevalence was highest in the Estuaire province in 2000, reaching 46%. It decreased until 2010, exhibiting strong spatial correlation (P < 0.001), decreasing slowly with distance. Hotspots were identified in north-western and western Gabon. Using the Spatial Durbin Error Model (SDEM), the relationship between the prevalence and insecticide-treated bed nets (ITNs) coverage was decreasing after 20% of coverage. The prevalence in a cluster decreased significantly with the increase per percentage of ITNs coverage in the nearby clusters, and per degree Celsius of day land surface temperature in the same cluster. It slightly increased with the number of wet days and mean temperature per month in neighbouring clusters.ConclusionsIn summary, this study showed evidence of strong spatial effect influencing malaria prevalence in household clusters. Increasing ITN coverage by 20% and prioritizing hotspots are essential policy recommendations. The effects of environmental factors should be considered, and collaboration with the national meteorological department (DGM) for early warning systems is needed.

Malaria incidence and prevalence: An ecological analysis through Six Sigma approach

Malaria is the leading cause of death globally, especially in sub-Saharan African countries claiming over 400,000 deaths globally each year, underscoring the critical need for continued efforts to combat this preventable and treatable disease. The objective of this study is to provide statistical guidance on the optimal preventive and control measures against malaria. Data have been collected from reliable sources, such as World Health Organization, UNICEF, Our World in Data, and STATcompiler. Data were categorized according to the factors and sub-factors related to deaths caused by malaria. These factors and sub-factors were determined based on root cause analysis and data sources. Using JMP 16 Pro software, both linear and multiple linear regression were conducted to analyze the data. The analyses aimed to establish a linear relationship between the dependent variable (malaria deaths in the overall population) and independent variables, such as life expectancy, malaria prevalence in children, net usage, indoor residual spraying usage, literate population, and population with inadequate sanitation in each selected sample country. The statistical analysis revealed that using insecticide treated nets (ITNs) by children and individuals significantly decreased the death count, as 1,000 individuals sleeping under ITNs could reduce the death count by eight. Based on the statistical analysis, this study suggests more rigorous research on the usage of ITNs.

Socioeconomic, Demographic, and Environmental Factors May Inform Malaria Intervention Prioritization in Urban Nigeria.

Urban population growth in Nigeria may exceed the availability of affordable housing and basic services, resulting in living conditions conducive to vector breeding and heterogeneous malaria transmission. Understanding the link between community-level factors and urban malaria transmission informs targeted interventions. We analyzed Demographic and Health Survey Program cluster-level data, alongside geospatial covariates, to describe variations in malaria prevalence in children under 5 years of age. Univariate and multivariable models explored the relationship between malaria test positivity rates at the cluster level and community-level factors. Generally, malaria test positivity rates in urban areas are low and declining. The factors that best predicted malaria test positivity rates within a multivariable model were post-primary education, wealth quintiles, population density, access to improved housing, child fever treatment-seeking, precipitation, and enhanced vegetation index. Malaria transmission in urban areas will likely be reduced by addressing socioeconomic and environmental factors that promote exposure to disease vectors. Enhanced regional surveillance systems in Nigeria can provide detailed data to further refine our understanding of these factors in relation to malaria transmission.

Evaluation of the protective efficacy of Olyset®Plus ceiling net on reducing malaria prevalence in children in Lake Victoria Basin, Kenya: study protocol for a cluster-randomized controlled trial

BackgroundIn the Lake Victoria Basin of western Kenya, malaria remains highly endemic despite high coverage of interventions such as insecticide-impregnated long-lasting insecticidal nets (LLIN). The malaria-protective effect of LLINs is hampered by insecticide resistance in Anopheles vectors and its repurposing by the community. Ceiling nets and LLIN with synergist piperonyl butoxide (PBO-LLIN) are novel tools that can overcome the problems of behavioral variation of net use and metabolic resistance to insecticide, respectively. The two have been shown to reduce malaria prevalence when used independently. Integration of these two tools (i.e., ceiling nets made with PBO-LLIN or Olyset®Plus ceiling nets) appears promising in further reducing the malaria burden.MethodsA cluster-randomized controlled trial is designed to assess the effect of Olyset®Plus ceiling nets on reducing malaria prevalence in children on Mfangano Island in Homa Bay County, where malaria transmission is moderate. Olyset®Plus ceiling nets will be installed in 1315 residential structures. Malaria parasitological, entomological, and serological indicators will be measured for 12 months to compare the effectiveness of this new intervention against conventional LLIN in the control arm.DiscussionWider adoption of Olyset®Plus ceiling nets to complement existing interventions may benefit other malaria-endemic counties and be incorporated as part of Kenya’s national malaria elimination strategy.Trial registrationUMIN Clinical Trials Registry UMIN000045079. Registered on 4 August 2021.

Unravelling the impact of insecticide-treated bed nets on childhood malaria in Malawi

BackgroundTo achieve malaria elimination it is essential to understand the impact of insecticide-treated net (ITNs) programmes. Here, the impact of ITN access and use on malaria prevalence in children in Malawi was investigated using Malaria Indicator Survey (MIS) data.MethodsMIS data from 2012, 2014 and 2017 were used to investigate the relationship between malaria prevalence in children (6–59 months) and ITN use. Generalized linear modelling (GLM), geostatistical mixed regression modelling and non-stationary GLM were undertaken to evaluate trends, spatial patterns and local dynamics, respectively.ResultsMalaria prevalence in Malawi was 27.1% (95% CI 23.1–31.2%) in 2012 and similar in both 2014 (32.1%, 95% CI 25.5–38.7) and 2017 (23.9%, 95% CI 20.3–27.4%). ITN coverage and use increased during the same time period, with household ITN access growing from 19.0% (95% CI 15.6–22.3%) of households with at least 1 ITN for every 2 people sleeping in the house the night before to 41.7% (95% CI 39.1–44.4%) and ITN use from 41.1% (95% CI 37.3–44.9%) of the population sleeping under an ITN the previous night to 57.4% (95% CI 55.0–59.9%). Both the geostatistical and non-stationary GLM regression models showed child malaria prevalence had a negative association with ITN population access and a positive association with ITN use although affected by large uncertainties. The non-stationary GLM highlighted the spatital heterogeneity in the relationship between childhood malaria and ITN dynamics across the country.ConclusionMalaria prevalence in children under five had a negative association with ITN population access and a positive association with ITN use, with spatial heterogeneity in these relationships across Malawi. This study presents an important modelling approach that allows malaria control programmes to spatially disentangle the impact of interventions on malaria cases.

Prevalence of Malaria Among Children Attending AlFaw Teaching Hospital, El-Gedaref State, Sudan

Introduction: In Sudan, malaria is still a major cause of death and the primary cause of death for children. A strategy for reducing and eradicating malaria may be developed with the help of knowledge regarding the prevalence of the disease among children. The goal of this study was to examine the prevalence of malaria in children at the AlFaw Teaching Hospital, as well as the risk factors and contributing factors. Methods: In this study, questionnaires were used to gather socioeconomic, demographic, and vector control data from the families of children aged 1 day to 17 years in order to detect Plasmodium falciparum and other spp. Age, gender, place of residence, usage of a vector control intervention, and mother’s educational degree are all associated with malaria positivity. Results: During June through July 2022, 400 children who visited AlFaw teaching hospital participated in a facility-based crosssectional survey. P. falciparum species made up 279 of the Plasmodium species (70%), and other species consisted of 121 (30%). Children who regularly spend the night outside and those who live in homes with stagnant water in the complex had higher probabilities of contracting malaria than those who regularly sleep under long-lasting insecticide-treated nets. Malaria diagnoses were more common in children of mothers with no formal education than in children of mothers with secondary education. Conclusion: Children who were patients at AlFaw teaching hospital had a significant malaria prevalence. In this study, a higher proportion of moderate parasitemia was also detected, and those with the highest prevalence of malaria were in the age group of 0–17 years. The main correlations with malaria were irregular usage of bed nets, night-out times, and parents not receiving malaria health education. To reduce the impact of malaria, the local government and other concerned organizations should put more emphasis on routine insecticide-treated net (ITN) use, infections linked to nighttime exposure to the outdoors, environmental management, and modification of attitudes toward malaria prevention and control through health education. Other actions that can be taken to decrease this impact include improving health management and planning, redistributing resources (including consultants) at the central and regional levels, and implementing appropriate training programs on the management of severe malaria at all levels.

Stratification at the health district level for targeting malaria control interventions in Mali

Malaria is the leading cause of morbidity and mortality in Mali. Between 2017 and 2020, the number of cases increased in the country, with 2,884,827 confirmed cases and 1454 reported deaths in 2020. We performed a malaria risk stratification at the health district level in Mali with a view to proposing targeted control interventions. Data on confirmed malaria cases were obtained from the District Health Information Software 2, data on malaria prevalence and mortality in children aged 6–59 months from the 2018 Demographic and Health Survey, entomological data from Malian research institutions working on malaria in the sentinel sites of the National Malaria Control Program (NMCP), and environmental data from the National Aeronautics and Space Administration. A stratification of malaria risk was performed. Targeted malaria control interventions were selected based on spatial heterogeneity of malaria incidence, malaria prevalence in children, vector resistance distribution, health facility usage, child mortality, and seasonality of transmission. These interventions were discussed with the NMCP and the different funding partners. In 2017–2019, median incidence across the 75 health districts was 129.34 cases per 1000 person-years (standard deviation = 86.48). Risk stratification identified 12 health districts in very low transmission areas, 19 in low transmission areas, 20 in moderate transmission areas, and 24 in high transmission areas. Low health facility usage and increased vector resistance were observed in high transmission areas. Eight intervention combinations were selected for implementation. Our work provides an updated risk stratification using advanced statistical methods to inform the targeting of malaria control interventions in Mali. This stratification can serve as a template for continuous malaria risk stratifications in Mali and other countries.

Factors associated with knowledge about malaria prevention among women of reproductive age, Tete Province, Mozambique, 2019\u20132020

BackgroundMozambique is a malaria endemic country with an estimated prevalence of malaria in children 6–59 months old that is twice as high in rural areas (46.0%) as in urban areas (18.0%). However, only 46.0% of women aged 15–49 years had complete knowledge about malaria in 2018. This study aimed to identify the factors associated with malaria knowledge among women of reproductive age in a high malaria burden district.MethodsData from a cross-sectional study, using a population-based malaria research study in Mágoe District, 2019, were analysed. This analysis included women aged 15–49 years. A multivariate logistic regression model was developed to determine factors associated with complete knowledge of malaria that calculated adjusted odds ratio (aOR) and 95% confidence interval (CI) at a p < 0.05 significance level. Complete malaria knowledge was defined as when a woman correctly identified: fever as a malaria symptom, mosquito bites as the means of malaria transmission, mosquito nets as a tool for malaria prevention, malaria as curable, and were able to name an anti-malarial.ResultsA total of 1899 women were included in this analysis. There was complete malaria knowledge among 49% of the respondents. Seventy one percent mentioned fever as one of malaria symptoms, 92% mentioned mosquito bite as the cause of malaria infection, 94% identified that mosquito nets prevent malaria, 92% agreed that malaria has cure, and 76% were able to name at least one anti-malarial medicine. In the multivariate analysis, the following characteristics were associated with significantly higher odds of having complete malaria knowledge: having a secondary school or above education level (adjusted Odds Ratio, aOR = 2.5 CI [1.3–4.6] p = 0.005), being from the middle socioeconomic status group (aOR = 1.5 CI [1.1–2.1] p = 0.005), being from older age group of 35–39 (aOR = 1.9; CI [1.1–3.1] p < 0.001), having 1–2 children (aOR = 1.8; CI [1.2–2.6] p = 0.003), and having interviews completed in Portuguese or Cinyungwe (aOR = 2.3; CI [1.3–4.1] p = 0.004 and aOR = 2.1; CI [1.5–2.8] p < 0.001, respectively).ConclusionMost women in this study had some malaria knowledge, but gaps in complete knowledge remained. In order to broaden knowledge, educational messages about malaria prevention should be more effectively targeted to reach younger, less-educated women and in non-dominant languages.

Socioeconomic determinants of malaria prevalence among under five children in Uganda: Evidence from 2018-19 Uganda Malaria Indicator Survey.

Malaria remains a significant public health problem in sub-Saharan Africa, affecting mainly children and pregnant women. In Uganda, little is known about the underlying socioeconomic correlates of malaria prevalence in children under five years of age. This study investigated the link between malaria infection among children under five and the socio-economic factors in Uganda. We estimated the prevalence of malaria among under-five children using secondary data from the 2019 Uganda Malaria Indicator Survey. Malaria infection status was ascertained using rapid diagnostic tests (RDTs). Multivariable logistic regression was employed to explore the socioeconomic correlates of malaria prevalence. Svyset command in STATA 16.0 was used to control for survey design. Overall, 6503 children were enrolled in the study. Of these, 1516 children tested positive for malaria, leading to an observed malaria prevalence of 23.3%. Older children (OR 1.01, 95%CI 1.01-1.01), and those from rural areas (OR 1.8, 95%CI 1.09-2.84) had higher odds of malaria infection. Children belonging to the highest wealth quintile had lower odds of malaria (OR 0.2, 95%CI 0.08-0.44). Indoor residual spray (OR 0.2, 95%CI 0.10-0.51) and use of treated bed nets (OR 0.8, 95%CI 0.69-0.99) were associated with reduced odds of malaria in children Interpretation & conclusion: Despite the significant increase in malaria preventive interventions in the last two decades, malaria remains highly prevalent in Ugandan under-five children. Indoor residual spraying and treated bed nets need to be promoted countrywide to reach malaria control targets. It is also imperative that appropriate education on proper and consistent use of mosquito bed-nets should be emphasized alongside embracing living habits that reduce the chances of mosquito bites like staying indoors.

Prevalence of Malaria among Children under Five Years in the Niger Delta Region of Nigeria

Background: Malaria still remains an overwhelming cause of morbidity and mortality among children under five years of age, especially in sub-Saharan Africa. The aim of this study was to determine the prevalence of Plasmodium parasitemia among children below 5 years of age in Akwa-Ibom, Delta and Rivers States, located in the Niger Delta region of Nigeria.&#x0D; Methodology: A cross sectional study of 2630 children, selected by multistage sampling from Akwa-Ibom, Delta and Rivers States of Nigeria between April and June 2019. Parasitological diagnosis was by Plasmodium falciparum histidine-rich protein 2-based malaria rapid diagnostic test (RDT) and microscopy of giemsa-stained blood smears. Demographic information was collected using soft copies of pretested interviewer-administered questionnaires via the Open Data Kit application installed on android phones. Data analysis was performed using the statistical software SPSS version 25. Frequency, percentages, and Chi-square test were used to interpret data at a confidence interval of 95% and a p-value less than 0.05 was regarded as statistically significant.&#x0D; Results: A total of 2630 children less than 5 years old were included in the study, 1016 from Akwa-Ibom and 807 each from Delta and Rivers states respectively. Malaria parasitaemia was detected in 230 (8.6%) and 198 (7.4%) children by RDT and microscopy, respectively. RDT used in this survey has high diagnostic accuracy (98.8%) compared to microscopy.&#x0D; Conclusion: The study shows a decline in the prevalence of malaria in children under 5 years. It also demonstrates the reliability of the RDTs in the diagnosis of malaria. The use of RDTs is thus further recommended especially in peripheral centers where the access to skilled microscopists and laboratory infrastructure may be lacking.

A mobile digital technology (Fionet™) to improve accuracy, completeness and timeliness of research data compared with a non-digital system in Kenya

The World Health Organization’s Global Malaria Program implemented a multi-country study to assess the entomological and epidemiological impact of long-lasting insecticide treated nets (LLINs) and indoor residual spray (IRS). Study activities included home visits to perform a LLIN survey and malaria testing of children in the household. In Kenya, Fionet™, a technology for automated malaria Rapid Diagnostic Test (mRDT) processing and interpretation at point-of-care, was evaluated against traditional paper-based methods and manual mRDT processing. Objective: To measure and compare the accuracy of diagnosis, completeness, and timeliness of data transmission between a digital mobile solution (Fionet™) and a paper-based system. Methodology: A randomised cluster sampling design of two cohorts: 1) an Active Infection Detection cohort, and 2) an Active Case Detection cohort was undertaken between November 2013 and April 2014. Community Health Workers (CHWs) visited rural households to: 1) measure malaria prevalence in children under the age of five using mRDTs, and 2) survey the use and physical status of LLINs in the household. Ten clusters were randomly assigned to Fionet™ to perform automated testing, interpretation, and survey data capture. Fionet™ transmitted all the tests and survey data to a cloud-based database. Results: A total of 1770 households were visited, 437 children tested, and 742 LLINs inspected. Fionet™ significantly improved the quality of data gathered; a two-fold increase in adherence to study protocols using Fionet™ resulted in more accurate data, data completeness was 10 times higher than with paper-based collection methods, and 87% of data were available in less than one day. Fionet™ significantly improved data quality and management, which enhanced the health system’s ability to meet the research objectives. This technology can help ensure accurate, complete, and timely availability of data. Future studies should incorporate mobile technologies such as Fionet™ to improve RDT based diagnostics of malaria and data quality.

Investigating the Effect of Prompt Treatment on Malaria Prevalence in Children Aged below Five Years in Zambia: A Nested Case-Control Study in a Cross-Sectional Survey

Background. In a highly malaria endemic country like Zambia, prompt treatment of cases is known to reduce morbidity and mortality; however, it is not known whether it has a role as an effective prevention strategy because of the presence of asymptomatic chronic carriers who do not seek treatment and maintain the reservoirs of infection in the population. This study investigated the role of treatment of malaria cases as a prevention strategy in low, moderate, and high endemic settings. Methods. A nested case-control design was employed using datasets from a large countrywide national Malaria Indicator Survey of 2015. Self-reported malaria cases (n = 209) who took treatment in the two weeks preceding the survey were matched with controls (n = 511) who did not report malaria and did not take treatment during the same period using nearest neighbour propensity score matching for age, sex, and district. The data were analysed using conditional logistic regression in STATA version 15.1. Results. The malaria cases were more likely to be from rural areas (p=0.001), poorest households (p=0.049), and who lived in improvised housing structures (p=0.004) compared with the controls. Data from low and moderate malaria endemic areas did not have sufficient cases for the analysis to proceed; however, data from high endemic areas showed borderline evidence (p=0.054) that prompt treatment reduces the risk of malaria by almost half in the short-term aOR 0.057 (95% CI 0.32–1.01). Conclusion. We found borderline evidence which suggests that prompt treatment of malaria cases even in high endemic areas has potential to reduce the risk of malaria by almost half in the short term.

BCG vaccination is associated with reduced malaria prevalence in children under the age of 5 years in sub-Saharan Africa

IntroductionMalaria continues to be a major cause of morbidity and mortality in sub-Saharan Africa (SSA) without effective interventions. Bacillus Calmette-Guérin (BCG) vaccine possesses protective non-specific effects, which extend beyond protection...

The impact on malaria of biannual treatment with azithromycin in children age less than 5\xa0years: a prospective study

BackgroundThe MORDOR study, a cluster randomized clinical trial, showed that single-dose azithromycin (20 mg/kg) administered biannually for 2 years to preschool children reduced mortality; a study was conducted to determine its effect on clinical symptomatic episodes of malaria as a potential mechanism for mortality benefit.MethodsA randomized control trial (RCT) was conducted, whereby 30 randomly selected communities in Kilosa District, Tanzania were randomized to receive 6-monthly treatment of children ages 1–59 months with single-dose azithromycin (20 mg/kg) vs. placebo. A prospective cohort study was nested within the RCT: children, aged 1 to 35 months at baseline, were randomly selected in each community and evaluated at 6-monthly intervals for 2 years. At each visit, the children were assessed for recent or ongoing fever and anti-malarial treatment; a rapid diagnostic test (RDT) for malaria was performed. The two major outcomes of interest were prevalence of RDT positivity and clinical malaria. The latter was defined as RDT-positivity with fever at time of evaluation and/or reported fever in the 3 days prior to evaluation. Methods that account for correlations at community level and within individuals over time were used to evaluate associations.ResultsAt baseline, the prevalence rates in the children in the azithromycin and placebo arms were 17.6% vs. 15.5% for RDT positivity (p = 0.76) and 6.1% vs. 4.3% (p = 0.56) for clinical malaria. There was a decline in both RDT-positivity and clinical malaria over time in both arms. The difference by treatment assignment was not significant for clinical malaria; it was significant for RDT-positivity with greater odds of decline in the placebo arm (p = 0.01).ConclusionsLack of evidence for a significant difference in the prevalence of clinical malaria in children at any visit following treatment suggests that the effect of single-dose azithromycin on malaria is at best transient and limited in scope. Chance overrepresentation of non-seasonal transmission in the communities in the azithromycin arm may account for higher rates of RDT-positivity and less decline over time.Trial registration Clinicaltrials.gov NCT02047981

Patterns of anopheline feeding/resting behaviour and Plasmodium infections in North Cameroon, 2011\u20132014: implications for malaria control

BackgroundEffective malaria control relies on evidence-based interventions. Anopheline behaviour and Plasmodium infections were investigated in North Cameroon, following long-lasting insecticidal net (LLIN) distribution in 2010.MethodsDuring four consecutive years from 2011 to 2014, adult mosquitoes were collected indoors, outdoors and in exit traps across 38 locations in the Garoua, Pitoa and Mayo-Oulo health districts. Anophelines were morphologically and molecularly identified, then analysed for blood meal origins and Plasmodium falciparum circumsporozoite protein (Pf-CSP). Blood from children under 5 years-old using LLINs was examined for Plasmodium infections.ResultsOverall, 9376 anophelines belonging to 14 species/sibling species were recorded. Anopheles gambiae (s.l.) [An. arabiensis (73.3%), An. coluzzii (17.6%) and An. gambiae (s.s.) (9.1%)] was predominant (72%), followed by An. funestus (s.l.) (20.5%) and An. rufipes (6.5%). The recorded blood meals were mainly from humans (28%), cattle (15.6%) and sheep (11.6%) or mixed (45%). Pf-CSP rates were higher indoors (3.2–5.4%) versus outdoors (0.8–2.0%), and increased yearly (χ2 < 18, df = 10, P < 0.03). Malaria prevalence in children under 5 years-old, in households using LLINs was 30% (924/3088).ConclusionsThe present study revealed the variability of malaria vector resting and feeding behaviour, and the persistence of Plasmodium infections regardless the use of LLINs. Supplementary interventions to LLINs are therefore needed to sustain malaria prevention in North Cameroon.

Care-seeking behaviour and treatment practices for malaria in children under 5\xa0years in Mozambique: a secondary analysis of 2011 DHS and 2015 IMASIDA datasets

BackgroundIn Mozambique, the prevalence of malaria in children under 5 years of age is among the highest in the world, but limited data exist on determinants of care-seeking behaviour for malaria. This study aimed at determining the trends and factors associated with care-seeking behaviour for fever among children under 5 years of age and to assess the treatment practices for malaria.MethodsSecondary data analysis of two cross-sectional studies. Descriptive statistics were used to summarize socio-economic and demographic characteristics of participants, using data from the 2011 Demographic and Health Survey and 2015 Indicators of Immunization, Malaria and HIV/AIDS Survey. Complex sampling logistic regression model was used to identify factors associated with care-seeking behaviour, with estimated adjusted odds ratio and respective 95% confidence intervals, only for 2015 IMASIDA data.ResultsA total of 10,452 and 5168 children under 5 years of age were enrolled in the 2011 DHS and 2015 IMASIDA, respectively. Care-seeking for fever in public and private sectors remained stable during this period (62.6%; 835/1432 in 2011 and 63.7%; 974/1529 in 2015). The main place where care was sought in both surveys was public hospitals (86.2%; 773/897 in 2011 and 86.7%; 844/974 in 2015). Prescription of anti-malarial drugs increased from 42.9% (385/897) in 2011 to 53.8% (524/974) in 2015. Artemether–lumefantrine was the most used anti-malarial drug for febrile children in both surveys and its use increased from 59.0% (219/373) in 2011 to 89.3% (457/512) in 2015. Data from 2015 elucidated that care-seeking was more common in children whose mothers had a secondary level of education (AOR = 2.27 [95% CI 1.15–4.49]) and among those in poorer quintile (AOR = 1.46 [95% CI 0.83–1.90]). Mothers with higher education level (AOR = 0.16 [95% CI 0.34–0.78]) were less likely to seek out care. People from Manica (AOR = 2.49 [1.03–6.01]), Sofala ([AOR = 2.91 [1.03–8.24]), Inhambane (AOR = 3.95 [1.25–12.45]), Gaza (AOR = 3.25 [1.22–8.65]) and Maputo Province (AOR = 2.65 [1.10–6.41]) were more likely to seek care than people from Maputo City.ConclusionData from this study showed that care-seeking in Mozambique remained suboptimal. Interventions to raise the awareness for early care-seeking during episodes of fever should be urgently reinforced and intensified.

True malaria prevalence in children under five: Bayesian estimation using data of malaria household surveys from three sub-Saharan countries

BackgroundMalaria is one of the major causes of childhood death in sub-Saharan countries. A reliable estimation of malaria prevalence is important to guide and monitor progress toward control and elimination. The aim of the study was to estimate the true prevalence of malaria in children under five in the Democratic Republic of the Congo, Uganda and Kenya, using a Bayesian modelling framework that combined in a novel way malaria data from national household surveys with external information about the sensitivity and specificity of the malaria diagnostic methods used in those surveys—i.e., rapid diagnostic tests and light microscopy.MethodsData were used from the Demographic and Health Surveys (DHS) and Malaria Indicator Surveys (MIS) conducted in the Democratic Republic of the Congo (DHS 2013–2014), Uganda (MIS 2014–2015) and Kenya (MIS 2015), where information on infection status using rapid diagnostic tests and/or light microscopy was available for 13,573 children. True prevalence was estimated using a Bayesian model that accounted for the conditional dependence between the two diagnostic methods, and the uncertainty of their sensitivities and specificities obtained from expert opinion.ResultsThe estimated true malaria prevalence was 20% (95% uncertainty interval [UI] 17%–23%) in the Democratic Republic of the Congo, 22% (95% UI 9–32%) in Uganda and 1% (95% UI 0–3%) in Kenya. According to the model estimations, rapid diagnostic tests had a satisfactory sensitivity and specificity, and light microscopy had a variable sensitivity, but a satisfactory specificity. Adding reported history of fever in the previous 14 days as a third diagnostic method to the model did not affect model estimates, highlighting the poor performance of this indicator as a malaria diagnostic.ConclusionsIn the absence of a gold standard test, Bayesian models can assist in the optimal estimation of the malaria burden, using individual results from several tests and expert opinion about the performance of those tests.

Combination of indoor residual spraying with long-lasting insecticide-treated nets for malaria control in Zambezia, Mozambique: a cluster randomised trial and cost-effectiveness study protocol

BackgroundMost of the reduction in malaria prevalence seen in Africa since 2000 has been attributed to vector control interventions. Yet increases in the distribution and intensity of insecticide resistance and...

Prevalence and associated determinants of malaria parasites among Kenyan children

BackgroundApproximately 80% of deaths attributed to malaria worldwide occurred mainly in Africa in 2015. Kenya is one of the major malaria endemic countries, making malaria the leading public health concern in this country. This study intended to document the prevalence of malaria and determine associated factors including socioeconomic status among children aged 6 months to 14 years in Kenya.MethodsThis study analyzed the secondary data extracted from the 2015 Kenya Malaria Indicator Survey (KMIS), a cross-sectional country representative survey. Associations of demographic, socioeconomic, community-based, and behavioral factors with the prevalence of malaria in children were analyzed using multivariable logistic regression analysis.ResultsData from 7040 children aged 6 months to 14 years were analyzed. The prevalence of malaria showed an upward trend in terms of age, with the highest prevalence among children aged 11–14 years. Prevalence was also higher among rural children (10.16%) compared to urban children (2.93%), as well as poor children (11.05%) compared to rich children (3.23%). The likelihood of having malaria was higher among children aged 10–14 years (AOR = 4.47, 95% CI = 3.33, 6.02; P < 0.001) compared with children aged under 5 years. The presence of anemia (AOR = 3.52, 95% CI = 2.78, 4.45; P < 0.001), rural residence (AOR = 1.71, 95% CI = 1.31, 2.22; P < 0.001), lack of a hanging mosquito net (AOR = 2.38, 95% CI = 1.78, 3.19; P < 0.001), primary education level of the household head (AOR = 1.15, 95% CI = 1.08, 2.25; P < 0.05), and other factors, such as the household having electricity and access to media such as television or radio, were also associated with the likelihood of infection.ConclusionThis study demonstrated the need to focus on awareness programs to prevent malaria and to use existing knowledge in practice to control the malaria burden in Kenya. Furthermore, this study suggests that improving the information available through the mass media and introducing behavior change communication and intervention program specifically for those of poor socioeconomic status will help to reduce malaria cases.