Prioritize Low-Income Rural Dwellers Across Africa in Malaria Prevention Efforts 


Households with low incomes and those in rural areas must be prioritized in the mass distribution of Insecticide Treated Nets, (ITNs) to prevent malaria deaths among children aged 6 to 59 months in sub-Saharan Africa, a new study has said. 

In the study, “Pooled prevalence and risk factors of malaria among children aged 6–59 months in 13 sub-Saharan African countries: A multilevel analysis using recent malaria indicator surveys” published by PLOS One journal on May 31, 2023, the authors found that older under-five children in large families with low income in rural areas are most vulnerable to malaria infection.

The WHO says the African region continues to carry a disproportionately high share of the global malaria burden. In 2021, the region was home to about 95% of all malaria cases and 96% of all deaths. Children under five years of age accounted for about 80% of all malaria deaths in the region. 

According to the authors, they pooled the prevalence and risk factors of malaria among children aged 6-69 months in 13 Sub-Saharan African countries. A multi-level analysis using recent malaria indicators

Data from Malaria Indicator Surveys (MIS)

Data for this study were drawn from Malaria Indicator Surveys (MIS), conducted recently in 13 Sub-Saharan African countries. A sample of 60,541 children aged from 6 to 59 months was used. STATA, a statistical software was used to clean, code, and analyze the data while multilevel logistic regression was employed to identify factors associated with malaria. The study had a Confidence Interval (CI) of 95% which shows the reliability of the data collected. 

Co-author for the studies, Dagmawi Chilot of Department of Human Physiology the University of Gondar School of Medicine, in Ethiopia told GBC that,  the motivation for the study was based on research by UNICEF which says nearly every minute, a child under five years dies of malaria, 


It was conducted on secondary data from the recent MIS of 13 SSA countries such as Burkina Faso, Ghana, Guinea, Kenya, Liberia, and Madagascar. The rest are Mali, Malawi, Mozambique, Nigeria, Sierra Leone, Senegal, and Tanzania.  

Chilot said children aged between six months and five years are at the highest risk of malaria because during this period they have lost maternal immunity and have not yet developed specific immunity to the infection.  

He said the study revealed that older under-five children living in large families with low incomes in rural areas are most vulnerable to malaria infection and the results indicate that ITN utilization and improved housing are promising means to effectively prevent malaria infection among children aged 6-59 months. 

Chilot said the “persistent and overwhelming burden of deaths among under-five children, indicates the urgent need for collective action against malaria. Adequate understanding of the socio-economic, environmental, and cultural factors is important to successfully prevent the burden.” 

He said their “study could be an important asset as it investigated both the individual and community level factors.” 

Dr. Nana Yaw Peprah, Deputy Programme Manager of the National Malaria Elimination Programme, (NMEP) in Ghana, described the study as a confirmation of an existing malaria epidemiology in Ghana. He said the NMEP continues to implement malaria interventions in line with the National Strategic Plan.  

Zero malaria, according to the Deputy Programme Manager, is attainable because the power lies in collective and individual actions. He stated that through advocacy with Community leaders, the NMEP continues sensitization at the community level and it leads and mobilizes all community members to be on board to eliminate malaria in Ghana.

Dr. Peprah disclosed that the under-five malaria case fatality rate in Ghana has seen a 57% reduction from 0.07% in 2019 to 0.03% in 2022, while malaria-related deaths in all ages have reduced from 333 per 1000 population in 2019 to 151 by the end of 2022, a 53% reduction.

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