Proximate Family Biosocial Variables Associated with Severe Malaria Disease among Under-Five Children in Resource-Poor Setting of a Rural Hospital in Eastern Nigeria.
BACKGROUND
Malaria threatens the life of under-five in rural Nigerian families. Although, factors that influence malaria in under-five are manifold. However, family biosocial factors may contribute to the variability of the clinical picture.


OBJECTIVE
To determine proximate family biosocial variable associated with severe malaria among under-five children in a resource-poor setting of a rural hospital in Eastern Nigeria.


METHODS
A cross-sectional study carried out on the families of under-five managed for malaria. Data extracted included family biosocial variables and diagnosis. An under-five child was defined to have malaria if the mother gave complaints of fever, vomiting, and other symptoms suggestive of malaria, had body temperature exceeding 37.5°C with the asexual forms of Plasmodium falciparum detected on the peripheral blood film. Severe malaria is the malaria that presents with life-threatening features like severe anemia and cerebral malaria.


RESULTS
The prevalence of severe malaria was 31.8% The family biosocial variables significantly associated with severe malaria were maternal low level of education (P = 0.031), family size >4 (P = 0.044), low social class of the family (P = 0.025), nonliving together of parents (P = 0.011), and poor access to health facilities (P = 0.038). The most significant predictor of severe malaria was nonliving together of parents (P = 0.000, odds ratio = 3.08, confidence interval = 1.64-5.10).


CONCLUSIONS
This study has demonstrated that some family biosocial variables are associated with severe malaria. These families should constitute at risk families that could be targeted for malaria interventional programs.
Department of Family Medicine, Federal Medical Centre, Umuahia, Abia, Nigeria.
Gabriel Uche Pascal
GU
Iloh
Department of Ophthalmology, Federal Medical Centre, Umuahia, Abia, Nigeria.
Abali
A
Chuku
Department of Public Health Technology, Federal University of Technology, Owerri, Imo, Nigeria.
Agwu Nkwa
AN
Amadi
Department of Family Medicine, Federal Medical Centre, Umuahia, Abia, Nigeria.
John Nnaemeka
JN
Ofoedu
Family variables; Nigeria; hospital; rural; severe malaria; under-five