Prevalence and socio-demographic determinants of malaria among febrile under- five children in Abobo district, Southwest Ethiopia: Cross-sectional study

Malaria ranks among Ethiopia's top ten causes of illness and mortality among children under five. The disease continues to pose a severe public health risk in malaria-endemic regions like the Abobo district. Information on malaria prevalence and its determinants among under-five year’s children in the Abobo district is missing. A facility-based cross-sectional study was conducted at Abobo Catholic Health Center in Abobo district, Southwest Ethiopia, from June 2022 to August 2022.  A total of 265 febrile children under the age of five were consecutively enrolled in the study. A structured questionnaire was used to collect data on socio-demographic characteristics, parental/caregiver knowledge, and malaria-determining factors. Malaria was diagnosed in the health center using the Malaria Rapid Diagnostic Test and Microscopy to confirm the presence of malaria parasites. Bivariate and multivariate logistic regression analyses were used to identify factors associated with malaria. This study comprised 265 participants, and the response rate was 100%. 36.2% of febrile children under five had malaria. Determinants like the presence of stagnant water (AOR = 0.203, 95% CI: 0.077, 0.537), and garbage heaps close to homes (AOR = 2.45, 95% CI: 1.41-4.26) were all related with an increased risk of contracting malaria. Compared to children who did not sleep under insecticide-treated nets, those who did were more likely to be protected from malaria infection (AOR = 0.238; 95% CI: 0.138-0.411). Malaria in Abobo town and the surrounding area disproportionately affected children under five. The most important determinants for malaria infections were living close to stagnant water, having garbage heaps surrounding the house, poor water drainage systems, and using insecticide-treated nets inadequately. Therefore, it is essential to strengthen community mobilization to improve the implementation of malaria prevention strategies and decrease the prevalence in the study area.