Factors associated with the risk of malaria among children: Analysis of Nigeria Malaria Indicator Survey, 2021

Abstract Purpose Malaria remains a burden globally, with the African region accounting for 94% of the overall disease burden and deaths in 2019. It is the major cause of morbidity and mortality among children in Nigeria. Thoughdifferent environmental factors have been assessedto influence the distribution and transmission of malaria vectors, there is a shortage of information on how they may influence malaria transmission among under-fives in Nigeria. Methods This study was based on thesecondary data analysis of the Nigeria Malaria Indicator Survey 2021. The study sample comprised 10,645 women (aged 15–49) who delivered a child in the 2 years preceding the survey. The studywas restricted to under-fives. We used logistic regression to identify factors associated with the risk of malaria. Results There was a positive association between the risk of malaria and Heard/seen malaria messages in the last six months (AOR:1.45, 95%CI: 1.23-1.70), houses with walls built using rudimentary materials (AOR=1.44, 95%CI: 1.09-1.91), at least six children living in the house (AOR:1.23, 95%CI: 1.01-1.49), children being 1 or more years old was associated with increased odds (AOR:1.92, 95%CI: 1.52-2.41 and AOR:1.91, 95%CI: 1.54-2.38), children from households with only treated nets (AOR:1.23, 95%CI: 1.04-1.46) and those from the North West or South East regions (AOR:1.56, 95%CI: 1.15-2.11 and AOR:1.51, 95%CI:1.04-2.19), respectively. All other predictors were not associated with the risk of malaria. Conclusion The factorsassociated with the risk of malaria in this study included sleeping under treated mosquito nets, the age of the children, residing in the northwest and southeast regions, wall construction material, six children and above in the household and heard/seen malaria messages in the last six months. Continuous health education and public health interventions,such as the provision of LLITNs and a portable water supply, will reduce the risk of malaria and improve the health and well-being of children under five years of age.