Department of Epidemiology and Biostatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Wogera District Health Office, North Gondar Zone, Gondar, Ethiopia.
PLoS One. 2021 Oct 11;16(10):e0257944. doi: 10.1371/journal.pone.0257944. eCollection 2021.
Malaria is a major public health problem in sub-Saharan Africa, and children are especially vulnerable. In 2019, an estimated 409,000 people died of malaria, most (274,000) were young children and 94% of the cases and deaths were in Africa. Prior studies in Ethiopia focused on the adult population and high transmission areas. Hence, this study aimed to determine the prevalence and associated factors of malaria in children under five years in low transmission areas.
A facility-based cross-sectional study was conducted among 585 under-five children who attended public health facilities in the Wogera district from September to October, 2017. Health facilities were selected by stratified cluster sampling, and systematic random sampling was held to select study participants from the selected facilities. Multivariable logistic regression was used to identify correlates of malaria.
Of 585 children who provided blood samples, 51 (8.7%) had malaria. The predominant Plasmodium species were P. falciparum 33 (65%) and P. vivax 18 (35%). Regularly sleeping under long-lasting insecticide treated nets (LLIN) was associated with decreased odds of malaria (AOR = 0.08, 95% CI: 0.01-0.09), and an increased odds of malaria was observed among children who live in households with stagnant water in the compound (AOR = 6.7, 95% CI: 3.6-12.6) and children who stay outdoors during the night (AOR = 5.5, 95% CI: 2.7-11.1).
The prevalence of malaria in the study population was high. Environmental and behavioral factors related to LLIN use remain potential determinants of malaria. Continued public health interventions targeting proper utilization of bed nets, drainage of stagnant water, and improved public awareness about reducing the risk of insect bites have the potential to minimize the prevalence of malaria and improve the health of children.
疟疾是撒哈拉以南非洲地区的一个主要公共卫生问题，儿童尤其容易受到影响。2019 年，估计有 40.9 万人死于疟疾，其中大多数（27.4 万人）是幼儿，94%的病例和死亡发生在非洲。此前在埃塞俄比亚进行的研究侧重于成年人群和高传播地区。因此，本研究旨在确定低传播地区五岁以下儿童疟疾的患病率及相关因素。
2017 年 9 月至 10 月，在沃格拉区的公共卫生机构中对 585 名 5 岁以下儿童进行了基于设施的横断面研究。卫生机构采用分层聚类抽样选择，从选定的设施中采用系统随机抽样选择研究参与者。采用多变量逻辑回归确定疟疾的相关因素。
在 585 名提供血液样本的儿童中，有 51 名（8.7%）患有疟疾。主要的疟原虫种类是恶性疟原虫 33 例（65%）和间日疟原虫 18 例（35%）。定期在长时效杀虫剂处理蚊帐（LLIN）下睡觉与降低疟疾的几率相关（AOR = 0.08，95%CI：0.01-0.09），而在居住在院内有死水的家庭中的儿童（AOR = 6.7，95%CI：3.6-12.6）和夜间在户外过夜的儿童（AOR = 5.5，95%CI：2.7-11.1）中，疟疾的几率会增加。
在所研究人群中，疟疾的患病率很高。与 LLIN 使用相关的环境和行为因素仍然是疟疾的潜在决定因素。持续开展公共卫生干预措施，旨在正确使用蚊帐、排干死水，并提高公众对减少昆虫叮咬风险的认识，有可能最大限度地减少疟疾的流行，并改善儿童的健康状况。
