Predictors of Malaria Prevalence and Coverage of Insecticide-Treated Bednets among Under-Five Children in the Buea Health District, South West Region, Cameroon

Abstract

Introduction: Cameroon is a hyperendemic country to malaria where it remains a major public health concern, especially amongst children under-five. Insecticide-treated bednets (ITBNs) is the main control strategies. This study aimed at determining the predictors of malaria prevalence and coverage of ITBNs among under-five children in the Buea Health District (BHD), South West Region of Cameroon in other to reduce the morbidity and mortality of malaria. Methods: A cross-sectional study was carried out in the BHD which is a malaria-hyperendemic area. Every head (female/male) of the household who was present at home at the time of data collection was randomly interviewed using a structured questionnaire. Under-five children were ascertained for malaria using microscopy, with a temperature of ≥37.50˚C. Results: Out of 391 children (mean age = 19.7 month, SD = 2.5) who were selected and ascertained for malaria, the overall malaria prevalence was 13.04% (95% CI: 10.04 - 16.78). In a multivariate analysis after adjusting for confounders, female parents/guardians (AOR = 0.53, 95% CI: 0.29 - 0.91) was associated with low risk of malaria while parents/guardians with no formal/primary educational (AOR = 3.3, 95% CI: 1.76 - 4.04) and children who did not use ITBN (AOR = 1.40, 95% CI: 1.08 - 2.51) were associated with an increased risk of malaria. Out of the selected children, 84.4% possessed ITBN (95% CI: 80.4 - 87.7) while 72.6% (95% CI: 67.9 - 76.8) used ITBN. In a multivariate after adjusting for confounders, Bova health area showed a significantly lower usage of ITBNs (χ2 = 14.053, p = 0.003). Conclusion: The findings indicate that increased ITBN usage, increased parents/guardians’ educational level and good knowledge of ITBN is required to lower the risk of under-five children being infected with malaria. Health area of residence greatly influences the direct relationship between bednets possession and usage. These, therefore, indicates the possession of ITBN doesn’t mean their usage. The Cameroon National malaria control programs should consider the realities of the living conditions of the population for the implementation of better policies.