Situational analysis of malaria in children aged 0–5 years and pregnant women in the Tiko Health District, Cameroon, since the inception of the Roll Back Malaria (RBM) strategy, 2011–2018

Malaria remains a major public health problem in endemic areas such as the Tiko Health District (THD), South West Region of Cameroon, despite the ongoing Roll Back Malaria (RBM) strategy. This study assessed the situational analysis of malaria in children aged 0–5 years and pregnant women in the THD from 2011 to 2018. The study employed a hospital-based retrospective-prospective cross-sectional design. Retrospective malaria prevalence and morbidity data were extracted from consultation, antenatal care (ANC), and laboratory registers of three randomly selected health facilities in the THD for 2011–2018. A cross-sectional survey was conducted using structured questionnaires administered to pregnant women and caregivers of children aged 0–5 years to assess their knowledge and self-reported utilization of Long-Lasting Insecticidal Nets (LLINs). The overall malaria prevalence between 2011 and 2018 was 79.10% (95% CI 76.36–80.82%) among pregnant women (out of 1000 records) and 76.02% among children aged 0–5 years (out of 9275 records). Among pregnant women with malaria, 79.39% (628/791) suffered from complicated malaria, while 62.09% (4378/7051) of children with malaria had uncomplicated malaria. The mortality rates during the study period were 0.19% (67/34825) among children aged 0–5 years and 0.02% (3/6583) among pregnant women. In the cross-sectional survey, 79.40% (214/270) of pregnant women and 81.61% (126/154) of caregivers reported that they or their children slept under LLINs the previous night. Only 54.70% of pregnant women demonstrated good knowledge about malaria in the cross-sectional survey. There was a significant association between caregivers’ knowledge about malaria and the utilization of LLINs by their children (χ 2 = 7.8742, p = 0.005). Despite implementation of the RBM strategy, malaria prevalence and morbidity remained high in the THD. Suboptimal knowledge and gaps in effective LLIN use and Intermittent Preventive Treatment in pregnancy (IPTp) uptake indicate the need for targeted community education, improved intervention coverage and enhanced health system capacity for surveillance and case management.