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Predictors of childhood malaria morbidity in insecticide treated bed net available households: A case control study in Shashego district, Southern Ethiopia.

Dawit Jember Tesfaye, Ermias Abera Turuse, Terefe Gone Fuge, Tigist Mohammed, Desalegn Tsegaw Hibistu, Teshome Abuka Abebo, Kebede Haile Misgana, Fanuel Belayneh Bekele, Abraham Abate Altaye, Henok Gebreyohaness Kebede, Menen Ayele Tumelisan

Background: To date malaria prevention mainly focuses on reduction of human and mosquito contact through insecticide treated bed net. In spite of 100% bed net coverage and marked reduction in malaria mortality in southern region of Ethiopia, malaria is still the leading cause of under-five morbidity. The aim of this study was to identify predictors of malaria among under-five children living in households having insecticide treated bed net. Methods: A community based case control study was conducted in Shashego district, Hadiya zone, Southern Ethiopia. Cases were under five children diagnosed with malaria, and controls were healthy under five children. A total of 310 under-five children paired with their mothers/care taker were selected from the community. Malaria status was determined using rapid diagnostic test. Structured questionnaire and anthropometric measurements were employed to collect data. Bivariate and multivariable logistic regression analysis was performed using SPSS version 20 software. P-value<0.05 and 95% CI was used to declare significant association. Results: Nearly seven among ten 44 (69.8%) cases had Plasmodium vivax malaria. Three in five (60%) cases and controls used insecticide treated nets regularly. Having rectangular bed net (AOR=11.89, 95% CI: 5.57, 25.37), low wealth index quintile (AOR=3.21, 95% CI: 1.31, 7.86), household surrounded with maize/enset plant (AOR 5.89, 95% CI: 2.16, 13.98), moderate (AOR=13.23, 95% CI: 2.41, 72.54) and severe stunting (AOR=8.29, 95% CI: 1.80, 38.19) were independent predictors of malaria. Conclusion: Prior to bed net distribution, the local community bed net shape preference should be considered for effective utilization and to reduce malaria cases. The finding also indicates poverty alleviation and reduction of chronic malnutrition plays significant role to avert malaria morbidity. Presence of enset plant around households and malaria risk needs further investigation.

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