Individual and Contextual Factors Associated with Malaria among Children 6–59 Months in Nigeria: A Multilevel Mixed Effect Logistic Model Approach

OBASOHAN, Phillips Edomwonyi, WALTERS, Stephen J., JACQUES, Richard and KHATAB, Khaled (2021). Individual and Contextual Factors Associated with Malaria among Children 6–59 Months in Nigeria: A Multilevel Mixed Effect Logistic Model Approach. International Journal of Environmental Research and Public Health, 18 (21).

ijerph-18-11234-v2.pdf - Published Version
Creative Commons Attribution.

Download (1MB) | Preview
Official URL:
Open Access URL: (Published version)
Link to published version::


Background/Purpose: Over the last two decades, malaria has remained a major public health concern worldwide, especially in developing countries leading to high morbidity and mortality among children. Nigeria is the world most burdened malaria endemic nation, contributing more than a quarter of global malaria cases. This study determined the prevalence of malaria among children at 6–59 months in Nigeria, and the effects of individual and contextual factors. Methods: This study utilized data from 2018 Nigeria Demographic and Health Survey (NDHS) involving a weighted sample size of 10,185 children who were tested for malaria using rapid diagnostic test (RDT). Given the hierarchical structure of the data set, such that children at Level-1 were nested in communities at Level-2, and nested in states and Federal Capital Territory (FCT) at Level-3, multilevel mixed effect logistic regression models were used for the analysis. Results: The proportion of children 6–59 months of age in Nigeria that had malaria fever positive as assessed by RDTs was 35.5% (3418/10,185), (CI: 33.9–37.1). Kebbi State had 77.7%, (CI: 70.2–83.5), which was the highest proportion of 6–59 months who were malaria positive, next in line was Katsina State with 55.5%, (CI: 47.7–63.1). The Federal Capital Territory (FCT), Abuja had the proportion of 29.6%, (CI: 21.6–39.0), malaria positive children of 6–59 months of age. Children between the age of 48 and 59 months were 2.68 times more likely to have malaria fever than children of ages 6–11 months (AOR = 2.68, 95% CI: 2.03–3.54). In addition, children from the rural area (AOR = 2.12, 95% CI: 1.75–2.57), were more likely to suffer from malaria infection compared to children from urban area. Conclusion: The study identified some individual and contextual predictors of malaria among children in Nigeria. These factors identified in this study are potential areas that need to be considered for policy designs and implementations toward control and total elimination of malaria-related morbidity and mortality among children in Nigeria.

Item Type: Article
Additional Information: ** From MDPI via Jisc Publications Router ** Licence for this article: **Journal IDs: eissn 1660-4601 **History: published 26-10-2021; accepted 23-10-2021
Uncontrolled Keywords: malaria, fever, Plasmodium falciparum, Falciparum vivax, under-five, determinants, risk factors
Identification Number:
SWORD Depositor: Colin Knott
Depositing User: Colin Knott
Date Deposited: 29 Oct 2021 09:19
Last Modified: 29 Oct 2021 09:19

Actions (login required)

View Item View Item


Downloads per month over past year

View more statistics