Determinants of malaria among under-five children in Ethiopia: Bayesian multilevel analysis
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RESEARCH ARTICLE
Open Access
Determinants of malaria among under-five children in Ethiopia: Bayesian multilevel analysis Setognal Birara Aychiluhm1*, Kassahun Alemu Gelaye2, Dessie Abebaw Angaw2, Getachew Asfaw Dagne3, Abay Woday Tadesse1, Adugna Abera4 and Dereje Dillu5
Abstract Background: In Ethiopia, malaria is one of the public health problems, and it is still among the ten top leading causes of morbidity and mortality among under-five children. However, the studies conducted in the country have been inconclusive and inconsistent. Thus, this study aimed to assess factors associated with malaria among under-five children in Ethiopia. Methods: We retrieved secondary data from the malaria indicator survey data collected from September 30 to December 10, 2015, in Ethiopia. A total of 8301 under-five-year-old children who had microscopy test results were included in the study. Bayesian multilevel logistic regression models were fitted and Markov chain Monte Carlo simulation was used to estimate the model parameters using Gibbs sampling. Adjusted Odd Ratio with 95% credible interval in the multivariable model was used to select variables that have a significant association with malaria. Results: In this study, sleeping under the insecticide-treated bed nets during bed time (ITN) [AOR 0.58,95% CI, 0.31– 0.97)], having 2 and more ITN for the household [AOR 0.43, (95% CI, 0.17–0.88)], have radio [AOR 0.41, (95% CI, 0.19– 0.78)], have television [AOR 0.19, (95% CI, 0.01–0.89)] and altitude [AOR 0.05, (95% CI, 0.01–0.13)] were the predictors of malaria among under-five children. Conclusions: The study revealed that sleeping under ITN, having two and more ITN for the household, altitude, availability of radio, and television were the predictors of malaria among under-five children in Ethiopia. Thus, the government should strengthen the availability and utilization of ITN to halt under-five mortality due to malaria. Keywords: Malaria microscopy test, Bayesian multilevel logistic regression, Ethiopia
Background Malaria is one of the most public health problems worldwide, in which 300 to 500 million cases and more than one million deaths were reported in 2018. Of these deaths, 90% were reported from Sub-Saharan African countries [1, 2]. This is equivalent to one child in sub-Saharan Africa dying of malaria every 2 min, and it is one of the * Correspondence: [email protected]; [email protected] 1 Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia Full list of author information is available at the end of the article
fourth leading cause of death of children under the age of 5 years in developing countries in general [1, 3]. In Ethiopia, 68% of the areas are endemic for malaria, and 60% of the country population are prone for infection of malaria [4]. Transmission of malaria mainly depends on the temperature, humidity, and rainfall [5]. In addition, its transmission is also determined by socioeconomic conditions, demographic factors, community-related factors,
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