Deworming Coverage and Associated Factors Among Children Aged 12-59 Months in Sub-Saharan Africa: A Multilevel...

Under the revised Demographic and Health Survey-8 (DHS-8) guidelines, deworming coverage is assessed only among children aged 12-59 months in accordance with World Health Organization recommendations. However, evidence for this age group in sub-Saharan Africa remains limited.

To assess deworming coverage and associated factors among children aged 12-59 months in sub-Saharan Africa.

A cross-sectional study was conducted using DHS data collected between 2021 and 2024 from 11 sub-Saharan African countries. A weighted sample of 96,830 children aged 12-59 months was included. Multilevel Poisson regression with a log link and robust variance estimation was used to estimate adjusted prevalence ratios (APRs) and 95% confidence intervals (CIs).

Overall, 47,426 of 96,830 children received deworming medication, giving coverage of 48.98% (95% CI: 48.67-49.30). Deworming coverage ranged from 32.0% in Burkina Faso to 66.0% in Kenya. Higher deworming prevalence was observed among children of mothers aged 25-34 years (APR = 1.04, 95% CI: 1.02-1.06) and 35-49 years (APR = 1.08, 95% CI: 1.06-1.10), those whose mothers had primary (APR = 1.19, 95% CI: 1.16-1.22), secondary (APR = 1.20, 95% CI: 1.18-1.26), or higher education (APR = 1.29, 95% CI: 1.20-1.34), and those who received vitamin A supplementation (APR = 2.75, 95% CI: 2.67-2.83). Children aged 36-59 months were also more likely to receive deworming medication (APR = 1.09, 95% CI: 1.08-1.11). Lower deworming prevalence was observed among children from households with ≥ 5 members (APR = 0.97, 95% CI: 0.95-0.98) and among those whose mothers reported distance to health facilities as a major problem (APR = 0.94, 95% CI: 0.92-0.96).

Nearly half of eligible children received deworming medication in sub-Saharan Africa. Strengthening integrated maternal and child health services, improving women's education and decision-making capacity, and expanding access to services in underserved communities are crucial to increase deworming coverage.