Prevalence and factors associated with malaria amongst under-five children in Senga hill district, Northern province Zambia.

Malaria is one of the major public health problems in developing countries like Zambia. Under-five years of age children are the most vulnerable group affected by malaria, accounting for 61% of all malaria deaths worldwide. Despite efforts to reduce the mortality and morbidity, the disease is still a prominent health problem in Senga Hill District. The District is described as a high risk area for malaria in the country. Knowledge of malaria prevalence and associated risk factors among under-five children in the district is insufficient. This study, therefore, was undertaken to assess the prevalence of malaria and associated risk factors amongst Under-Five Children in Senga Hill District, Northern Province, Zambia. Community-based cross-sectional study was conducted among under-five children in Senga Hill District from November 2022 to August, 2023. A structured questionnaire was used to collect data on hypothesised risk factors from the guardians or parents of children through face to face interview. A Care StartTM Malaria Rapid diagnostic test which can detect histidine-rich protein 2 of Plasmodium falciparum and Plasmodium lactate dehydrogenase of P. vivax was used to diagnose malaria. Bivariate analysis was used to determine associations between categorical variables, while for multivariable,
binary logistic regression analysis was used to identify predictors of malaria among under-five children in the district. A total of 216 under-five children took part in the study. The overall prevalence of malaria was 31.9%. Correct use of ITNs (OR = 0.089, 95% CL = 0.034, 0.232, p = <0.001), those households that reported IRS had been done (OR = 0.375, 95% CL = 0.178, 0.789, p = 0.010) and those that reported having a single mosquito net (OR = 0.137, 95% CL = 0.141, 0.891, p = 0.003) had significantly reduced odds of underfive children being positive to malaria, than those that had not. Male children had significantly higher odds (OR = 3.035, 95%CL = 1.518, 6.068, p = 0.028) of being malaria positive than females. The local authorities and other concerned bodies should focus on the regular and proper use of ITNs and changing attitudes towards ITNs as malaria prevention and control measures.