Prevalence and Risk Factors Associated With Malaria Infection in Children Attending Luangwa District Hospital, Zambia; A Facility-Based Cross-Sectional Study

ABSTRACT Introduction Malaria persists as a major public health issue globally, with sub-Saharan Africa, including Zambia, bearing a disproportionate burden of the disease, necessitating ongoing efforts to combat transmission and improve healthcare access and prevention strategies. This research was aimed at investigating the prevalence and associated risk factors of malaria infection in children attending Luangwa District Hospital, Zambia. Methods An analytical cross-sectional study was used and the study population included children attending the Out-Patient Department at Luangwa District Hospital. A structured questionnaire and a checklist were used to collect data on malaria infection status, demographic information, and potential risk factors were collected through interviews, medical records review, and laboratory testing. Prevalence rates were calculated using frequencies, and hypothesis tests using the Chi-square test while logistic regression was used to analyse associated factors to malaria infection. Results A total of 400 children with a mean age of five years participated in the study. Malaria was prevalent in two-thirds of the children (66.2%) with over 57.7% of the infected children presenting with a severe form of malaria and 42.3% having mild disease. 60% had a high malaria parasite density, whereas 40% showed a low density of the parasite. The odds of having malaria were higher for children who did not sleep under Insecticide Treated Nets (ITNs) compared to children who used ITNs (aOR = 24.6, CI = 10.8, 55.7, p-value < 0.001). Furthermore, children whose parents had a secondary-level education compared to parents with no formal education had 3.3 times increased odds of having malaria (aOR = 3.3, CI = 1.09, 9.98, p = 0.034). On the other hand, gender, age of the child, and age of the parent were not significantly associated with malaria infection. Conclusion This study found a high prevalence of malaria of 66% among children who attended Luangwa District Hospital indicating that Luangwa is still a hotspot with the low transmission province of Lusaka. Factors associated with malaria included not sleeping under ITNs and secondary education. Factors not associated with malaria included gender, age of the child and age of the parent.