Spatial Prevalence and Determinants of Malaria among under-five Children in Ghana

In Ghana malaria is an endemic disease and the incidence of malaria still accounts for 38.0% of all outpatient attendance with the most vulnerable groups being children under 5 years of age. In order to alleviate this problem, it is essential to design geographically targeted and cost-effective intervention mechanisms guided by up-to-date and reliable data and maps that show the spatial prevalence of the disease. The 2016 Ghana Malaria Indicator Survey data (N = 2,910 under-five children) were analyzed using model-based geostatistical methods with the two objectives to: (1) explore individual-, household-, and community-level determinant variables associated with malaria illness in U5 children, and (2) produce prevalence maps of malaria across the study locations in the country. The overall weighted prevalence of malaria by microscopy blood smear and rapid diagnostic tests were 20.63% (with 95% CI: 18.85% - 22.53%) and 27.82% (with 95% CI: 25.81% - 29.91%), respectively. Across regions of Ghana, the prevalence of malaria ranges from 5% in Greater Accra to 31% in Eastern region. Malaria prevalence was higher in rural areas, increased with child age, and decreased with better household wealth index and higher level of mothers education. Given the high prevalence of childhood malaria observed in Ghana, there is an urgent need for effective and efficient public health interventions in hot spot areas. The determinant variables of malaria infection that have been identified in this study as well as the maps of parasitaemia risk could be used in malaria control program implementation to define priority intervention areas.