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Deworming among preschool age children in sub-Saharan Africa: pooled prevalence and multi-level analysis
Daniel Gashaneh Belay1,2, Anteneh Ayelign Kibret3, Mengistie Diress4
1Department of Human Anatomy, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia. danielgashaneh28@gmail.com.
Insights
Deworming medication use in Sub-Saharan African preschool children is under 50%. Key factors influencing utilization include maternal education, household wealth, and media exposure, highlighting a need for integrated public health strategies.
Area of Science:
- Global Health
- Pediatric Health
- Parasitology
Background:
- Preschool-age children in Sub-Saharan Africa (SSA) face high risks of soil-transmitted helminths (STH) due to socioeconomic factors and poor sanitation.
- Limited data exists on deworming medication prevalence and associated factors in SSA's preschool-age children (pre-SAC).
Purpose of the Study:
- To determine the prevalence of deworming medication use among pre-SAC in SSA.
- To identify significant factors associated with deworming medication utilization in this population.
Main Methods:
- Analysis of Demographic and Health Survey (DHS) data from 192,652 children aged 24-59 months in SSA.
- A multi-level binary logistic regression model was employed to identify significant determinants.
- Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were calculated.
Main Results:
- The overall prevalence of deworming medication utilization was 45.03% (95% CI: 44.46%-45.60%).
- Significant factors included higher maternal education, increased household media exposure, richer wealth status, and vitamin A supplementation.
- Lower utilization was associated with larger family size, while rural residence showed a slight negative association.
Conclusions:
- Deworming medication utilization among pre-SAC in SSA remains below 50%, indicating a substantial public health gap.
- Maternal education, household characteristics, and access to health interventions like vitamin A supplementation are key determinants.
- Integrated strategies promoting women's education, media engagement, maternal employment, and targeted rural interventions are recommended.
Background:
Sub-Saharan Africa (SSA) preschool age children are more vulnerable to soil-transmitted helminths (STH) which caused millions of morbidity because of low socioeconomic status and lack of clean water and sanitation. Despite this problem, there is minimal evidence on the prevalence and factors associated with deworming medication utilization among preschool age children (pre-SAC) in SSA regions. Hence this study aimed to assess the prevalence and determinants of deworming among preschool age children in SSA.
Methods:
Demographic and Health Survey (DHS) data were used for this study with a total weighted 192,652 children aged 24-59 months. Taking deworming medication in the 6 months preceding the interview was our outcome of interest. A multi-level binary logistic regression model was fitted. Adjusted odds ratio (AOR) with 95% confidence interval (CI) was taken to identify significant variables.
Results:
The prevalence of deworming medication utilization among preschool age children in SSA was 45.03% (95% CI 44.46%, 45.60%), ranging from 41.82% in Malawi to 50.5% in Lesotho. It was 44.91% (95% CI 44.32%, 45.51%) among countries having endemic STH infection and 46.01% (95% CI 43.64%, 48.38%) for none endemic countries. Factors such as; secondary and above women education [AOR = 2.18; 95% CI 2.10, 2.26], occupation [AOR = 1.31; 95% CI 1.27, 1.34], having ≥ 11 family members [AOR = 0.68; 95% CI 0.64, 0.70], household media exposure [AOR = 1.16; 95% CI 1.13, 1.19] and richer wealth status [AOR = 1.23; 95% CI 1.16, 1.27], vitamin A supplementation [AOR = 6.18; 95% CI 6.02, 6.33] and living rural residence [AOR = 0.94; 95% CI 0.92, 0.98] have significantly associated with deworming among preschool age children.
Conclusions:
Utilization of deworming medication among pre-SAC children in sub-Saharan Africa is below half. Factors, such as the education status of women, family size, household media exposure, wealth status, diarrhea, vitamin A supplementation, and residence were significant variables. To increase the utilization of deworming medication for pre-SAC, WHO should work as an integrated approach with other stakeholders, by strengthening women's education, and media exposure. Maternal employment should be promoted and prior attention should be given to rural children.
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