Prevalence and factors associated with malaria amongst under-five children in Senga Hill District, Northern Province, Zambia, a community-based cross-sectional study

INTRODUCTION: Malaria is an urgent and high-priority public health issue. The persistent burden of malaria among under-five children in Zambia, with particular focus on Senga Hill District, remains a huge Challenge. This population subgroup continues to carry a disproportionate share of malaria morbidity and mortality, and therefore, research that identifies local prevalence and determinants of infection is highly relevant for malaria control and elimination strategies. METHODS: A community-based cross-sectional study was conducted among under-five children in Senga Hill District from November 2022 to August 2023. A total of 216 under-five children were subjected to a Care Start™ 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. At the same time, a structured questionnaire was administered to the parents or guardians to collect data on hypothesised risk factors for the disease. Bivariate analysis and binary logistic regression analysis was used to identify risk factors associated with malaria. RESULTS AND CONCLUSION: In this study, the overall malaria prevalence was 31% (95% CI = 26, 38%). Subsequent data analysis revealed that correct hanging of an ITN reduced the odds of being positive for malaria by 88% (OR = 0.012, 95% CI 0.00.05, 0.304). Having two insecticide treated nests (ITNs) and indoor residual spraying (IRS) done in the last spraying season reduced odds of being malaria positive by 86% (OR = 0.0.14, 95% CI 0.040, 0.510) and 58% (OR = 0.42, 95% CI 0.21, 0.85), respectively. Further, being a male child had increased odds of being positive by 204% (OR = 3.04, 95% CI 1.52, 6.07). These results show that the prevalence of malaria among the under-five children in Senga Hill was high. Thus, all concerned bodies, including the community should strengthen ownership and encourage correct use of ITNs and acceptance of IRS service acceptance to stop the transmission of the malaria.