Publication:

Multilevel modelling of the predictors of malaria among under-five children in Nigeria: how do housing types and source of drinking water count?

Background Malaria remains a major public health issue, especially in sub-Saharan Africa (SSA), which still bears the brunt of the disease, with under-5 children disproportionately affected and Nigeria being one of the countries severely impacted. The study investigated predictors of malaria among under-5 children in Nigeria, with special focus on the impacts of housing types and source of drinking water.

Methods Data analysis covered a weighted sample of 9,946 under-5 children from the 2021 Nigeria Malaria Indicator Survey. Descriptive and analytical analyses were conducted, including frequency distributions and logistic regression models at the multivariate level, using Stata software (version 15).

Results The results showed that over half of the children lived in improved houses (53.67%) and nearly three-quarters (74.75%) had access to improved drinking water. However, more than half (54.41%) were still exposed to malaria risk. Children living in houses built with improved materials had a 32% (aOR: 0.68, CI: 0.53-0.87) lower risk of malaria compared to those in unimproved houses. Additionally, those with access to improved drinking water sources had a 15% (aOR: 0.85, CI: 0.67-1.06) reduced risk of malaria infection.

Conclusions The study established a high malaria prevalence among under-5 children, even among those living in improved houses. Also, improved housing quality and access to clean drinking water significantly reduce the risk, highlighting the importance of environmental factors in preventing malaria. Policymakers should focus on enhancing housing and environmental conditions to prevent malaria, prioritising better homes, clean water access, and comprehensive prevention strategies, especially for high-risk areas and under-5 children.