| Description |
The focus of this dissertation is threefold: conduct a systematic review to identify literature regarding the use of malaria control methods, identify rates of control method use, and identify predictors associated with the combined use of control methods among African children under age five through Demographic and Health Surveys (DHS). A systematic review identified literature regarding malaria control methods utilizing DHS surveys. Sixtyfive articles met the review criteria and were evaluated for insecticide treated nets (ITN) use, indoor residual spray (IRS), and prompt/appropriate treatment. While DHS datasets are a rich source to identify malaria practices in African children, additional research considering the combined use of malaria control methods is needed. DHS surveys from three countries at two separate time points were then analyzed to identify rates of children under five who reported fever and utilized one or more malaria control methods (ITNs, IRS, and/or prompt/appropriate treatment). Independent use of ITNs ranged from 30% to 75%, IRS from 1% to 18%, and prompt/appropriate treatment from 3% to 25%. Combined use of all control methods ranged between <1% to 3%. Within this descriptive analysis, while some improvements to using control methods were noted over time, independent and combined use of these methods are inadequate. Within the predictor analysis, using univariate, multivariate, and multinomial regression analysis, variables such as child age, maternal education, wealth index, and residence location were evaluated as possible predictors of the independent or combined use of these control methods. Higher maternal education and iv wealth were found to be significant predictors of using one malaria control method among some of the populations. The sample sizes for using two and three methods were extremely small and significant associations among the variables were few and sporadic. In summary, there were no predictors that remained consistent across all surveys. This final analysis demonstrates the necessity for further evaluation of availability, access, and effective dissemination of these control methods both singularly and in combination to improve the transmission and impact of malaria in these endemic populations. |
