title: Prevalence and factors associated with malaria parasitaemia in children under the age of five years in Malawi: A comparison study of the 2012 and 2014 Malaria Indicator Surveys (MISs).
abstract: BACKGROUND
  Malaria is the main cause of morbidity and mortality among children under the age of five years in Malawi. The aim of this study was to compare the prevalence and factors associated with malaria parasitaemia among children under the age of five years in Malawi between the 2014 and 2012 Malaria Indicator Surveys (MISs).
  
  
  METHODS
  Data on demographic factors, vector control interventions, and blood for malaria test were collected from a representative sample of children under the age of five years in Malawi through multistage cluster sampling method. Data were analysed by chi-square test and logistic regression using complex samples analysis of the Statistical Package for the Social Sciences (SPSS) version 22.
  
  
  RESULTS
  The prevalence of malaria parasitaemia among children under the age of five years increased from 28% in 2012 to 33% in 2014 (p > 0.05). Likewise, the proportion of children using long-lasting insecticide-treated net (LLIN) increased significantly from 54% in 2012 to 65% in 2014 MIS (p < 0.05). The proportion of households that had used indoor residual spraying (IRS) was 9% for both surveys. In multivariate analysis, use of LLIN significantly predicted for malaria parasitaemia in the 2012 MIS but not in the 2014 MIS. Older children and those coming from the poorest families were significantly associated with having malaria parasites in both surveys.
  
  
  CONCLUSIONS
  The increase in the use of LLIN among children in 2014, did not result in the reduction of malaria parasitaemia in children. The use of LLIN significantly predicted for malaria parasitaemia among children in the 2012 MIS but not in the 2014 MIS. The results of this study underscore the need to increase the coverage of IRS, mosquito repellents and larvicide alongside LLINs in order to reduce the burden of malaria among children in Malawi.
authors.affiliation: St John's College of Nursing, Mzuzu, Malawi.
authors.forename: Maggie
authors.initials: M
authors.lastname: Zgambo
authors.affiliation: St John's College of Nursing, Mzuzu, Malawi.
authors.forename: Balwani Chingatichifwe
authors.initials: BC
authors.lastname: Mbakaya
authors.affiliation: Mzuzu University, Private Bag 201, Luwinga Mzuzu 2, Malawi.
authors.forename: Fatch Welcome
authors.identifier: http://orcid.org/0000-0003-3032-3495
authors.initials: FW
authors.lastname: Kalembo
mesh_terms: D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008288:Malaria / Q000097:blood* / Q000469:parasitology; D008295:Malawi; D008297:Male; D010961:Plasmodium / Q000302:isolation & purification*; D011795:Surveys and Questionnaires