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Profiling malaria infection among under-five children in the Democratic Republic of Congo
Jacques B O Emina1,2, Henry V Doctor3, Yazoumé Yé4
1Population and Health Research Institute, Kinshasa, Democratic Republic of Congo.
Insights
Malaria disproportionately affects children in the Democratic Republic of Congo (DRC). Child
Area of Science:
- Global Health
- Epidemiology
- Public Health
Background:
- Malaria remains a significant public health challenge in the Democratic Republic of Congo (DRC).
- In 2018, malaria caused 38% of morbidity and 36% of mortality in the DRC.
- Identifying socioeconomic factors is crucial for effective malaria control in children.
Purpose of the Study:
- To identify socioeconomic predictors of malaria infection in children aged 6-59 months in the DRC.
- To characterize the socioeconomic profile of children most at risk of malaria infection.
Main Methods:
- Utilized data from the 2013 DRC Demographic and Health Survey.
- Included 8,547 children aged 6-59 months tested for malaria via microscopy.
- Employed Chi-square Automatic Interaction Detector (CHAID) and logistic regression analyses.
Main Results:
- 25% of children in the sample were infected with malaria.
- Child's age, mother's education, province, and household wealth index were significant predictors.
- Malaria prevalence increased with age but decreased with higher maternal education and household wealth.
Conclusions:
- Malaria risk is influenced by a combination of environmental, socioeconomic factors, and program implementation.
- Provincial-level variations in risk highlight the need for tailored interventions.
- Targeted, multisectoral strategies are recommended for malaria elimination in the DRC.
Introduction:
In 2018, Malaria accounted for 38% of the overall morbidity and 36% of the overall mortality in the Democratic Republic of Congo (DRC). This study aimed to identify malaria socioeconomic predictors among children aged 6-59 months in DRC and to describe a socioeconomic profile of the most-at-risk children aged 6-59 months for malaria infection.
Materials And Methods:
This study used data from the 2013 DRC Demographic and Health Survey. The sample included 8,547 children aged 6-59 months who were tested for malaria by microscopy. Malaria infection status, the dependent variable, is a dummy variable characterized as a positive or negative test. The independent variables were child's sex, age, and living arrangement; mother's education; household's socioeconomic variables; province of residence; and type of place of residence. Statistical analyses used the chi-square automatic interaction detector (CHAID) model and logistic regression.
Results:
Of the 8,547 children included in the sample, 25% had malaria infection. Four variables-child's age, mother's education, province, and wealth index-were statistically associated with the prevalence of malaria infection in bivariate analysis and multivariate analysis (CHAID and logistic regression). The prevalence of malaria infection increases with child's age and decreases significantly with mother's education and the household wealth index. These findings suggest that the prevalence of malaria infection is driven by interactions among environmental factors, socioeconomic characteristics, and probably differences in the implementation of malaria programs across the country. The effect of mother's education on malaria infection was only significant among under-five children living in Ituri, Kasaï-Central, Haut-Uele, Lomami, Nord-Ubangi, and Maniema provinces, and the effect of wealth index was significant in Mai-Ndombe, Tshopo, and Haut-Katanga provinces.
Conclusion:
Findings from this study could be used for targeting malaria interventions in DRC. Although malaria infection is common across the country, the prevalence of children at high risk for malaria infection varies by province and other background characteristics, including age, mother's education, wealth index, and place of residence. In light of these findings, designing provincial and multisectoral interventions could be an effective strategy to achieve zero malaria infection in DRC.
