Malaria prevalence dynamics and risk covariates among children under 5 in Ghana: insights from a Bayesian multilevel
Killian Asampana Asosega1,2, Atinuke Olusola Adebanji3, Eric Nimako Aidoo3
1Department of Statistics and Actuarial Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti Region, Ghana killian.asosega@uenr.edu.gh.
Insights
Malaria infection risk in Ghanaian children under 5 is influenced by community factors like rainfall and individual factors such as insecticide-treated net (ITN) use and household wealth. These findings highlight the need for targeted interventions to reduce malaria prevalence.
Area of Science:
- Public Health
- Epidemiology
- Environmental Health
Background:
- Malaria poses a significant public health threat, particularly to children under five in developing nations.
- Understanding risk factors at both individual and community levels is crucial for effective malaria control strategies in Ghana.
Purpose of the Study:
- To investigate individual and community-level factors associated with malaria infection risk in children under five in Ghana.
- To identify key determinants for targeted public health interventions and malaria prevention programs.
Main Methods:
- A population-based, secondary cross-sectional study utilizing data from the 2019 Ghana Malaria Indicator Survey.
- Analysis of data from 3004 mothers and their children under five.
- Bayesian multilevel modeling employing Hamiltonian Monte Carlo methods to analyze malaria risk factors.
Main Results:
- Weighted malaria prevalence was 29.7% among children under five; community differences accounted for 8.9% of infection risk.
- Increased average annual rainfall correlated positively with malaria prevalence, while temperature and built-population index showed inverse relationships.
- Factors reducing malaria risk included rich households, insecticide-treated net (ITN) usage, and absence of anemia; Gurma ethnic background was linked to higher risk.
Conclusions:
- Malaria remains a substantial health burden for young children in Ghana, necessitating multifaceted interventions.
- Community-level strategies focusing on sanitation and education, alongside individual-level preventive measures like ITN use, are vital.
- Addressing socioeconomic and environmental determinants can significantly mitigate malaria infections, improving child health and quality of life.
Objective:
Malaria is a major public health concern in most developing countries, with children under 5 years being mainly at risk. We investigated the contribution of individual and community-level covariates to the risk of malaria infection (treatment with artemisinin-based combination therapy for fever or tested positive for malaria via a rapid diagnostic test within 2 weeks prior to the survey) in children under 5 years in Ghana.
Design:
Population-based secondary cross-sectional study on the 2019 Ghana Malaria Indicator Survey SETTING: Ghana.
Participants And Methods:
Secondary malaria data on 3004 mothers and their children under 5 years from the recent 2019 Ghana Malaria Indicator Survey were analysed. Bayesian multilevel modelling under Hamiltonian Monte Carlo is applied to malaria data.
Results:
The results indicate a weighted malaria prevalence of 29.7% (95% CI: 0.28 to 0.31) among children under 5, and nearly 10% (8.9%) of the risk of malaria infection significantly varied by community differences. The average annual rainfall positively correlates with the prevalence of malaria in a community, while temperature and the built-population index inversely influence it. At the cluster level, the average annual rainfall significantly increased the risk of malaria infection among children under 5 years (adjusted OR (aOR)=17.46, 95% CrI: 1.86 to 167.34). Malaria infections among children under 5 are attributed to household/individual and community-level characteristics. Children from rich households (aOR=0.66, 95% CrI: 0.50 to 0.87), who sleep under insecticide-treated nets (ITNs) (aOR=0.79, 95% CrI: 0.65 to 0.95) and are not anaemic have significantly reduced the risk of malaria infection than those from poor households, children with severe anaemia and those who do not sleep under ITNs at night. Children under 5 years from Gurma (aOR=1.82, 95% CrI: 1.92 to 2.86) ethnic backgrounds are linked to a high risk of contracting malaria, while those from the Mole-Dagbani (aOR=0.70, 95% CrI: 0.51 to 0.98) and Grusi (aOR=0.55, 95% CrI: 0.32 to 0.93) ethnic groups have significantly reduced the risk of malaria infection. All other considered factors were not significantly associated with malaria risk among children under 5 years in this study.
Conclusion:
Malaria remains a serious health burden to children under 5 years. These findings call for individual and community-level measures, including improved sanitation and preventive education campaigns, to help reduce malaria infections among children under 5 in Ghana, to mitigate malaria infections among children under 5 in Ghana, thereby promoting their health and quality of life (Sustainable Development Goal 3).
More Related Videos
Related Concept Videos
01:26Introduction to Epidemiology
01:08Prevalence and Incidence
Prevalence indicates the proportion of individuals in a population who have a specific disease or health...
01:21Causality in Epidemiology
01:29Bias in Epidemiological Studies
01:25Statistical Methods for Analyzing Epidemiological Data
01:26Principles of Disease Surveillance