Prevalence of Malaria and Associated Factors among Children under 5 Years Following Mass Net Campaigns and Indoor Residual Spraying in Amolatar District-Northern Uganda: Cross-Sectional Study

Abstract Background: Mass LLIN distribution campaigns and indoor residual spraying (IRS) have been identified by the WHO as effective approaches for malaria prevention and control. Despite the scale-up of interventions towards the control and elimination of malaria, it is still endemic in 91 countries worldwide, with 3.3 billion people at risk of developing it. In 2015, 212 million malaria cases occurred globally, resulting in 429,000 deaths, 92% of which were in Africa. In 2019, 409,000 people died of malaria—mostly vulnerable children in sub-Saharan Africa. Methods: A community-based, cross-sectional research design using a quantitative data collection method was used. A semi-structured questionnaire was used. Bivariate and multivariate logistic regression analyses were performed to identify factors associated with the prevalence of malaria among <5 years. Results: The intended respondents (238) were interviewed, and up to 44.1% (105/238) of the children tested positive for malaria. According to the multivariate analysis, living with a married caretaker (AOR=2.54, 95% CI=1.23-5.25) had a statistically significant association with malaria incidence, and poor perceptions of LLIN use had 68% increased odds of contracting malaria. However, children who stayed far from water bodies (AOR=0.07, 95% CI=0.01-0.56) had reduced odds of developing malaria. Conclusions and recommendations: Malaria remains the major public health problem among children under 5 years of age in the Amolatar district. Living with married caretakers, having poor perceptions of LLIN use and living near water bodies were risk factors for malaria. DHTs to strengthen malaria prevention and control strategies among children <5 years, health information dissemination about eliminating stagnating water bodies, and addressing poor perceptions of mothers of children <5 years.