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