Malaria in Children under Five Years and Associated Factors in Artisanal Mining and Non-Mining Districts in the Upper East Region, Ghana

Abstract

Background: Malaria remains a leading public health problem in about 97 nations worldwide. Throughout the world, about 214 million new malaria cases are reported every year and over three billion persons are at risk of malaria. Approximately 90% of all malaria deaths occur in Africa. Africa continues to shoulder heaviest burden of malaria cases. Global demands for natural resources is fueling land use, saddled with unsatisfactory environmental burden in developing countries. We conducted a cross sectional study to determine proportion of malaria in children under five years in artisanal mining and non-mining areas and factors associated with malaria in the districts in the Upper East Region, Ghana. Methods: A cross-sectional study was conducted to compare proportion of malaria in children under five and associated factors in artisanal mining and non-mining districts. Data was abstracted from the facility records for children under five. A face to face interview was conducted for caregivers with children under five in the hospital. Categorical variables of the characteristics of the study participants were analysed into frequencies and proportions and presented in tables. The continuous variables such as age were analysed into means and standard deviations. Two samples proportion test was used to compare whether difference exist between the districts at 95% significant level. Chi square test and Odds ratio were used to examine an association between exposure variables and malaria. Malaria was the dependent variable and demography were independents variables. Univariate analysis was done to determine an association between exposure variables (age, sex, occupation, marital status, income level, educational status, and households’ number) and malaria. Logistic regression model was fitted to correctly predict factors that strongly associated with malaria infection in the districts Ethical clearance was obtained from Ethical Review Committee of Ghana Health Service. Written permission was sought from Regional Health Director of Ghana Health Service, Upper East Region. Results: Data on 11380 children under five years was extracted from hospital records and 525 caregivers were interviewed. The proportion of malaria was 39.2 % (95%. CI: 38.01%- 40.40%. p< 0.001) in children in the mining district as against 43.8% (95%, CI: 42.41% – 45.19%. p< 0.001) in the non-mining. Proportion of severe malaria was 27.1% (95%, CI: 25.7% - 28.3%) in the mining district compared with 57.47% (95%, CI: 56.0% - 58.8%) in the non-mining district. The child age, district the child resides, educational status of caregiver, occupation of caregiver and bed net (ITN) possession significantly associated with malaria in children under five years in study areas. Conclusion: The findings suggested a relatively low proportion of malaria morbidity and severe malaria in children under five in the artisanal mining as against the non-mining district. Age of child, socioeconomic factors of caregiver and education status were associated with malaria in children in the study areas. Efforts of controlling malaria in these districts have been intensified but could be enhanced with high coverage of ITN possession, health education and vector control activities at wetland and dam sites.