Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania.
University of Galway, Galway, Ireland.
BMC Public Health. 2024 Jun 24;24(1):1687. doi: 10.1186/s12889-024-19206-1.
Malaria remains a significant public health challenge in Sub-Saharan Africa (SSA), particularly affecting under-five (UN5) children. Despite global efforts to control the disease, its prevalence in high-risk African countries continues to be alarming, with records of substantial morbidity and mortality rates. Understanding the association of multiple childhood, maternal, and household factors with malaria prevalence, especially among vulnerable young populations, is crucial for effective intervention strategies.
This study examines the prevalence of malaria among UN5 children in selected high-risk SSA countries and analyzes its association with various childhood, maternal, and household factors.
Data from the Malaria Indicator Surveys (MIS) spanning from 2010 to 2023 were analyzed. A weighted sample of 35,624 UN5 children from seven countries in sub-Saharan Africa (SSA) known for high malaria prevalence was considered in the analyses. Descriptive statistics and modified Poisson regression analysis were used to assess the association of multiple factors with malaria prevalence. Stata version 15 software was used in analyzing the data and statistical significance was set at a 5% significance level.
The overall pooled prevalence of malaria among the studied population was 26.2%, with substantial country-specific variations observed. In terms of child factors, a child's age was significantly associated with malaria prevalence (APR = 1.010, 95% CI: 1.007-1.012). Children of mothers with higher education levels (APR for higher education = 0.586, 95% CI: 0.425-0.806) and Fansidar uptake during pregnancy (APR = 0.731, 95% CI: 0.666-0.802) were associated with lower malaria risk. Children from middle-wealth (APR = 0.783, 95% CI: 0.706-0.869) and rich (APR = 0.499, 95% CI: 0.426-0.584) households had considerably lower malaria prevalence compared to those from poor households. Additionally, rural residency was associated with a higher risk of malaria compared to urban residency (APR = 1.545, 95% CI: 1.255-1.903).
The study highlights a notable malaria prevalence among under-five (UN5) children in high-risk SSA countries, influenced significantly by factors such as maternal education, Fansidar uptake during pregnancy, socioeconomic status, and residency. These findings underscore the importance of targeted malaria prevention strategies that address these key determinants to effectively reduce the malaria burden in this vulnerable population.
疟疾仍然是撒哈拉以南非洲（SSA）的一个重大公共卫生挑战，尤其影响五岁以下儿童（UN5）。尽管全球努力控制这种疾病，但在高危非洲国家，疟疾的流行率仍然令人震惊，发病率和死亡率都很高。了解多种儿童、产妇和家庭因素与疟疾流行率的关联，特别是在弱势年轻人群中，对于制定有效的干预策略至关重要。
本研究调查了撒哈拉以南非洲（SSA）七个高疟疾风险国家中 UN5 儿童的疟疾流行率，并分析了其与多种儿童、产妇和家庭因素的关联。
分析了 2010 年至 2023 年期间的疟疾指标调查（MIS）数据。对来自七个高疟疾流行率的撒哈拉以南非洲（SSA）国家的 35624 名 UN5 儿童进行了加权样本分析。采用描述性统计和修正泊松回归分析评估了多种因素与疟疾流行率的关联。使用 Stata 版本 15 软件分析数据，统计显著性水平设为 5%。
研究人群中疟疾的总体 pooled 流行率为 26.2%，各国之间存在显著差异。就儿童因素而言，儿童年龄与疟疾流行率显著相关（APR=1.010，95%CI：1.007-1.012）。母亲受教育程度较高（APR for higher education=0.586，95%CI：0.425-0.806）和怀孕期间使用 Fansidar 的儿童（APR=0.731，95%CI：0.666-0.802）患疟疾的风险较低。来自中等富裕（APR=0.783，95%CI：0.706-0.869）和富裕（APR=0.499，95%CI：0.426-0.584）家庭的儿童患疟疾的流行率明显低于来自贫困家庭的儿童。此外，与城市居住相比，农村居住与疟疾风险增加相关（APR=1.545，95%CI：1.255-1.903）。
该研究突出了撒哈拉以南非洲（SSA）高危国家五岁以下儿童（UN5）中显著的疟疾流行率，这一现象受到多种因素的显著影响，包括产妇教育、怀孕期间使用 Fansidar、社会经济地位和居住地点。这些发现强调了针对这些关键决定因素制定有针对性的疟疾预防策略的重要性，以有效降低这一脆弱人群的疟疾负担。
