Malaria and associated factors among under-five children in Borena pastoral communities, southern Ethiopia.

Background: Malaria continues to be an important threat to public health and infects millions of children under 5 years of age each year. Although Ethiopia has set targets for at-risk group interventions to eradicate and manage malaria, the illness is still a serious public health problem in areas where it is endemic, especially in the unique lowlands in the Borena zone.

Objective: This study aimed to determine the prevalence of malaria and associated factors among children in Borena's pastoral communities, Oromia Regional State, southern Ethiopia, in 2022.

Methods: A community-based cross-sectional study was conducted from 1 March to 30 April 2022 among 437 randomly selected households with children under 5 years of age in pastoral communities in the Borena zone. Data were collected through face-to-face interviews with structured and pretested questionnaires and blood sample examination using microscopy. Thick and thin blood smears were prepared and examined under a microscope at a health center to confirm malaria cases. The data were analyzed using SPSS version 25. Bivariate and multivariable logistic regression analyses were used to identify factors associated with malaria, and a -value <0.05 was used to declare statistical significance.

Result: The prevalence of malaria among children under 5 years of age was 27.8% (95% CI = 23.5-32.1), and the prevalence rates of , , and mixed malaria were 68.4%, 25.6%, and 6%, respectively. Regarding the proportion of malaria among age groups, 81% of children under 5 years of age between 48 and 59 months were malaria-positive. In this study, fever within the last week (AOR = 13.34, 95% CI = 6.37-27.95) and not sleeping under insecticide-treated nets (ITNs) (AOR = 3.10, 95% CI =1.95-4.92) were significantly associated with malaria. The age of the children was negatively associated with malaria prevalence.

Conclusion: The prevalence of malaria among children under 5 years old was high during the rainy season in this pastoral region of Ethiopia. Factors such as fever within the last week and not sleeping in insecticide-treated nets were significantly associated with malaria. Therefore, to reduce malaria-related infections and deaths among children under 5 years of age, the government ought to enhance the availability and utilization of insecticide-treated nets (ITNs).