589. Prevalence and Predictors of Malaria among Children in Zambézia Province, Mozambique
Session: Poster Abstract Session: Oh One World: Infections from Near and Far
Thursday, October 27, 2016
Room: Poster Hall
Posters
  • Poster_IDWeek_SCIPmalaria_Carlucci_589_Final.pdf (273.7 kB)
  • Background:

    Malaria is the leading cause of death among children in Mozambique. Prevalence and factors associated with malaria are not well studied among children in rural Zambézia Province. Whether prevalence of malaria varies across diverse districts within the province is unknown.

    Methods:

    A cross-sectional survey of female heads-of-household was conducted during April/May 2014, a period of peak malaria transmission. Data were collected on up to 2 randomly selected children aged 6-59 months per household. The outcome of interest was report of symptomatic malaria confirmed by diagnostic test in the past 30 days. Analyses accounted for the two-stage cluster sample design. Malaria prevalence was calculated for the province and 3 oversampled districts – Alto Molócuè, Morrumbala, and Namacurra. Multivariable logistic regression was used to identify associations with malaria diagnosis, including district, age, sex, education, bed net use, urban setting, income, roofing material, and pig farming.

    Results:

    Data were collected on 2317 children. 50% were female and median age was 2 years. 60% of children slept under bed nets the night prior to the survey, but utilization varied between districts (range 49-89%)(p<0.001). 44% of children had fever in the past 30 days, 91% of those sought care at a health facility, 66% of those had either a malaria rapid diagnostic test or blood smear, and 68% of those had a positive test result. There were significant differences in prevalence of fever (p=0.006), health-seeking (p<0.001), and diagnostic testing (p=0.035) between districts. Province-wide prevalence of malaria was 13%, and among focus districts ranged from 14% in Morrumbala to 17% in Namacurra (p<0.001). Among children diagnosed with malaria, higher maternal education (OR 1.81; 95%CI 1.25-2.62), urban setting (OR 1.75; 95%CI 1.04-2.94), and higher income (OR 1.45; 95%CI 1.01-2.08) were independently associated with malaria diagnosis.

    Conclusion:

    Malaria is highly prevalent among children in Zambézia Province, Mozambique, and varies significantly between diverse districts. Factors facilitating access to health services are associated with malaria diagnosis. These findings should inform resource allocation in the fight against malaria in Mozambique.

    James Carlucci, MD1, Meridith Blevins, MS2, Melanie Lopez, MPH3, Charlotte Buehler Cherry, MS, MPH4, Ann Green, MPH4, Lazaro González-Calvo, PhD4, Troy Moon, MD, MPH1 and Ogumaniha-SCIP Zambézia Consortium, (1)Division of Pediatric Infectious Diseases, Vanderbilt University Medical Center, Nashville, TN, (2)Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN, (3)World Vision US, Federal Way, WA, (4)Vanderbilt Institute for Global Health, Nashville, TN

    Disclosures:

    J. Carlucci, None

    M. Blevins, None

    M. Lopez, None

    C. Buehler Cherry, None

    A. Green, None

    L. González-Calvo, None

    T. Moon, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.