Prevalence and associated risk factors of malaria among under-five years children in Ilugalan district, Oromia Region, Western Ethiopia

Abstract

Background: Under-five children are at high risk of malaria-associated morbidity and mortality, however studies on community-based malaria in under-five children in Ethiopia are limited. Hence this study was conducted to investigate prevalence and associated risk factors among under-five children in the Ilu Galan district. Methods: A community-based cross-sectional study was conducted from April to June 2023. Among five Kebeles selected by random sampling, 557 under-five children were chosen using systematic sampling. Malaria presence was assessed by microscopic examination and rapid diagnostic tests. Data on sociodemographic and risk factors were collected using a structured questionnaire. Bivari-ate and multivariable logistic regression identified predictors with adjusted odds ratios, 95% confi-dence intervals, and P < 0.05 as statistically significant. Results: The prevalence of malaria among under-five children was 5.2% (95% CI = 3.5-7.4). The majority (71.4%) were infected with P. falciparum, followed by P. vivax (25%), and mixed infection (3.6%). Staying outdoors at night (AOR=3.09; 95% CI=1.01-9.48), ITN utilization (AOR=0.26; 95% CI=0.07-0.94), presence of eaves (AOR=4.08; 95% CI=1.20-13.44), less than 1 km distance from the river (AOR=4.32; 95% CI=1.19-15.62), and stagnant water nearby (AOR=11.40; 95% CI=3.71-35.02) increased malaria odds. Conclusion: This study found a 5.2% malaria prevalence among under-five children, mainly caused by Plasmodium falciparum. Key risks included outdoor exposure, proximity to rivers, stagnant wa-ter, and poor housing. Promoting ITN use and addressing environmental risks are essential for pre-.