University of Livingstonia, Livingstonia, Malawi.
School of Social Work, McGill University, Montreal, Canada.
Malar J. 2020 Aug 27;19(1):308. doi: 10.1186/s12936-020-03382-7.
Malaria is a leading cause of morbidity and mortality among children under 5 years in Malawi, and especially among those from rural areas of central Malawi. The goal of this study was to examine the prevalence and determinants of malaria infection among children in rural areas of Dowa district in central Malawi.
A multistage, cross-sectional study design was used to systematically sample 523 child-mother dyads from postnatal clinics. A survey was administered to mothers and a rapid malaria infection diagnostic test was administered to children. The main outcome was positive malaria diagnostic tests in children. Logistic regressions were used to determine risk factors associated with malaria among children aged 2 to 59 months.
The prevalence of malaria among children under 5 years was 35.4%. Results suggest that children of mothers who experienced recent intimate partner violence (IPV) were more likely to be diagnosed with malaria (AOR: 1.88, 95% CI 1.19-2.97; P = 0.007) than children of mothers who did not. Children of mothers who had no formal education were more likely to be diagnosed with malaria (AOR: 2.77, 95% CI 1.24-6.19; P = 0.013) than children of mothers who had received secondary education. Children aged 2 to 5 months and 6 to 11 months were less likely to be diagnosed with malaria (AOR: 0.21, 95% CI 0.10-0.46; P = 0.000 and AOR: 0.43; 95% CI 0.22-0.85; P = 0.016, respectively) than children aged 24 to 59 months.
The prevalence of malaria infection among children in the study area was comparable to the national level. In addition to available malaria control programmes, further attention should be paid to children whose mothers have no formal education, children aged 24 to 59 months, and children of mothers that are exposed to IPV in the area.
疟疾是马拉维五岁以下儿童发病率和死亡率的主要原因，尤其是在马拉维中部农村地区。本研究的目的是调查马拉维中部多瓦地区农村地区儿童疟疾感染的流行率和决定因素。
采用多阶段、横断面研究设计，从产后诊所系统抽取 523 名母婴对子。对母亲进行调查，对儿童进行快速疟疾感染诊断检测。主要结局是儿童疟疾诊断检测阳性。采用逻辑回归确定 2 至 59 个月儿童疟疾相关的危险因素。
5 岁以下儿童疟疾的患病率为 35.4%。结果表明，经历近期亲密伴侣暴力（IPV）的母亲的孩子更有可能被诊断出患有疟疾（AOR：1.88，95%CI 1.19-2.97；P=0.007），而未经历 IPV 的母亲的孩子。母亲未接受正规教育的儿童更有可能被诊断出患有疟疾（AOR：2.77，95%CI 1.24-6.19；P=0.013），而接受过中等教育的母亲的孩子。2 至 5 个月和 6 至 11 个月大的儿童被诊断出患有疟疾的可能性较低（AOR：0.21，95%CI 0.10-0.46；P=0.000 和 AOR：0.43；95%CI 0.22-0.85；P=0.016），而 24 至 59 个月大的儿童。
研究地区儿童疟疾感染的流行率与全国水平相当。除了现有的疟疾控制方案外，还应进一步关注该地区母亲未接受正规教育、24 至 59 个月大的儿童以及遭受 IPV 影响的儿童。
