Prevalence of malaria infection and the impact of mosquito bed net distribution among children aged 6–59 months in Ghana: Evidence from the Ghana demographic health and malarial indicator surveys

IF 2 Q3 INFECTIOUS DISEASES Parasite Epidemiology and Control Pub Date : 2023-05-01 DOI:10.1016/j.parepi.2023.e00302

John Tetteh , Ernest Yorke , Vincent Boima , Alfred Edwin Yawson

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Abstract

Objective

To assess the prevalence of malaria infection and further quantify the impact of mosquito bed net distribution on malaria infection among children aged 6–59 months in Ghana.

Methods

A cross-sectional study using Ghana Demographic Health (GDHS) and Malaria Indicator (GMIS) surveys (2014 GDHS, 2016 GMIS, and 2019 GMIS). The exposure and the main outcomes were mosquito bed net use (MBU) and malaria infection (MI). Relative percentage change (Δ) and prevalence ratio (PR) were estimated to assess the changes and the risk of MI by MBU respectively. The Propensity-score matching treatment effect model was employed to estimate the average treatment effect (ATE) of MBU on MI. All analyses were performed using Stata 16.1 and p-value<0.05 was deemed significant.

Results

The study involved 8781 children aged 6–59 months. MI ranged from 25.8%(22.3–29.7) in 2019 GMIS to 40.6%(37.0–44.2) in 2014 GDHS and the prevalence was significantly high among children who used mosquito bed net. The relative percentage change in MI prevalence showed a significant reduction rate and was high among non-MBU (p-value<0.05). In all, the adjusted PR of MI among children exposed to MBU was 1.21(1.08–1.35), 1.13(1.01–1.28), and 1.50(1.20–1.75) in 2014 GDHS, 2016 GMIS, and 2019 GMIS respectively. The average MI among participants who slept in mosquito bed net significantly increased by 8%(0.04 to 0.12), 4%(0.003 to 0.08), and 7%(0.03 to 0.11) in 2014 GDHS, 2016 GMIS, and 2019 GMIS respectively.

Conclusion

Even though malaria infection prevalence among children aged 6–59 months is decreasing, the reduction rate seems not to be directly linked with mosquito bed nets distribution and/or use in Ghana. For a continued distribution of mosquito bed nets, and for Ghana to achieve her Malaria Strategic Plan (NMSP) 2021–2025, program managers should ensure effective use of the distributed nets in addition to other preventive measures and nuanced consideration of community behaviours in Ghana. The effective use and care of bed nets should be emphasized as part of the distribution.

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加纳6-59个月儿童中疟疾感染率和蚊帐分发的影响:来自加纳人口健康和疟疾指标调查的证据

目的评估加纳6-59月龄儿童疟疾感染流行情况，并进一步量化发放蚊帐对儿童疟疾感染的影响。方法采用加纳人口健康(GDHS)和疟疾指标(GMIS)调查(2014年GDHS、2016年GMIS和2019年GMIS)进行横断面研究。暴露和主要结果为蚊帐使用(MBU)和疟疾感染(MI)。估计相对百分比变化(Δ)和患病率(PR)，分别评估MBU的变化和心肌梗死的风险。采用倾向-得分匹配治疗效果模型估计MBU对心肌梗死的平均治疗效果(ATE)。所有分析均采用Stata 16.1进行，p值<0.05认为显著。结果该研究涉及8781名6-59个月大的儿童。2019年GMIS的MI为25.8%(22.3-29.7)，2014年GDHS的MI为40.6%(37.0-44.2)，使用蚊帐的儿童患病率明显较高。心肌梗死患病率的相对百分比变化显示出显著的降低率，并且在非mbu组中较高(p值0.05)。总体而言，2014年GDHS、2016年GMIS和2019年GMIS中，MBU暴露儿童的MI调整PR分别为1.21(1.08-1.35)、1.13(1.01-1.28)和1.50(1.20-1.75)。2014年GDHS、2016年GMIS和2019年GMIS中，睡在蚊帐中的参与者的平均MI分别显著增加了8%(0.04至0.12)、4%(0.003至0.08)和7%(0.03至0.11)。结论尽管加纳6-59月龄儿童的疟疾感染率正在下降，但下降率似乎与蚊帐的分发和/或使用没有直接联系。为了继续分发蚊帐，并使加纳实现其2021-2025年疟疾战略计划(NMSP)，除了采取其他预防措施和细致考虑加纳的社区行为外，项目经理还应确保有效使用分发的蚊帐。蚊帐的有效使用和护理应作为分发的一部分加以强调。

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来源期刊

Parasite Epidemiology and Control Medicine-Infectious Diseases

CiteScore

5.70

自引率

3.10%

发文量

审稿时长

17 weeks

期刊介绍： Parasite Epidemiology and Control is an Open Access journal. There is an increasing amount of research in the parasitology area that analyses the patterns, causes, and effects of health and disease conditions in defined populations. This epidemiology of parasite infectious diseases is predominantly studied in human populations but also spans other major hosts of parasitic infections and as such this journal will have a broad remit. We will focus on the major areas of epidemiological study including disease etiology, disease surveillance, drug resistance and geographical spread and screening, biomonitoring, and comparisons of treatment effects in clinical trials for both human and other animals. We will also look at the epidemiology and control of vector insects. The journal will also cover the use of geographic information systems (Epi-GIS) for epidemiological surveillance which is a rapidly growing area of research in infectious diseases. Molecular epidemiological approaches are also particularly encouraged.