Prevalence and associated risk factors of malaria among under-five years children in Ilugalan district, Oromia Region, Western Ethiopia

Abstract

Background: Under-five children are at high risk of malaria-associated morbidity and mortality, however studies on community-based malaria in under-five children in Ethiopia are limited.  Hence this study was conducted to investigate prevalence and associated risk factors among under-five children in the Ilu Galan district. 

Methods: A community-based cross-sectional study was conducted from April to June 2023. Among five Kebeles that selected by random sampling, 557 under-five children were selected using systematic sampling technique. The presence of malaria was assessed by microscopic examination of thick and thin smear and rapid diagnostic test. Data on sociodemographic and risk factors were collected using a pre-tested structured questionnaire. Bivariate and multivariable logistic regression model was used for analysis. Predictors were identified using adjusted odds ratios with 95% confidence interval and P < 0.05 was considered statistically significant. 

Results: The prevalence of malaria among under-five children was 5.2% (95% CI = 3.5-7.4). The majority (71.4%) were infected with P. falciparum, followed by P. vivax (25%). Staying out-door at night (AOR=3.09;95% CI=1.01-9.48), utilization of ITN (AOR=0.26;95% CI=0.07-0.94), Presence of eaves on the house (openings in the roof or walls that allow mosquito entry) (AOR=4.08; 95% CI=1.20-13.44), less than 1km distance of house hold from the river (AOR=4.32;95% CI=1.19-15.62) and presence of stagnant water nearby house (AOR=11.40; 95% CI=3.71-35.02) were found to increase the odds of malaria infection.

Conclusion: This study highlights a malaria prevalence of 5.2% among under-five children, with Plasmodium falciparum accounting for 71.4% of infections. Key risk factors identified were staying outdoors at night, household proximity to rivers, presence of stagnant water nearby, and having eaves on the house. The use of insecticide-treated nets played a great role in preventing malaria. These findings suggest that malaria prevention strategies should still focus on promoting ITN use, addressing environmental risk factors, and improving housing conditions.