Estimating the under-five malaria risk in Uganda based on the nearest neighbour matched analysis technique

Abstract

Introduction: Malaria still remains a global burden especially in the under-five despite efforts made towards reducing it. The most recommended vector control methods are; use of insecticide treated nets (ITNs) or long lasting insecticide nets (LLINs) and use of indoor residual spraying (IRS). However, these innovations may not have the same effect on malaria risk in the under-five. This study therefore aimed at assessing; the effect of ITNs/LLINs on malaria risk, the effect of IRS on malaria risk, and the effect of ITNs/LLINs on IRS, using nearest neighbours matched analysis. Methods: Nearest neighbour matched analysis was used to match the treated and control units by taking each treated unit and searching for the control unit with the nearest neighbours without replacement. Results: The results revealed a significant and negative effect of ITNs/LLINs and IRS on malaria risk [ATET=-0.05; 95% CI= -0.07 – -0.02] and [ATET=-0.12; 95% CI= -0.15 – -0.09] respectively. It also found a significant and positive effect of ITNs/LLINs on IRS [ATET=0.03; 95% CI= 0.01 – 0.05]. Conclusions: The implementation of policies and programs towards effective use of ITN/LLIN and IRS can reduce the burden of under-five malaria in Uganda. Keywords: Indoor residual spraying; insecticide treated nets; long lasting insecticide nets; Malaria; nearest neighbour matching; treatment effects; Uganda.