Investigating the Socioeconomic Influences on Paediatric Severe Malaria Incidence in Ghana, 2019: A Hospital-Based Case Control Study

Abstract

Introduction: Malaria is one of the biggest killers of children in Sub-Saharan Africa(1). The Volta Region in Ghana has one of the highest prevalence of malaria in the country and while recent research has sought to improve malaria diagnostics(2,3), not much has been done to investigate the socioeconomic drivers of delayed health-seeking in this population. This study aims to build upon Meerman et al’s study in 2005(4), which found socioeconomic factors quadrupled the odds of a child developing severe malaria (SM)- by investigating the socioeconomic factors related to SM in children in the Ho Teaching Hospital in Ho, Ghana.

Methods: Data was collected from parents/caregivers of patients diagnosed at the Ho Teaching Hospital through quantitative questionnaires. All data was analysed using STATA.15 through regression analysis.

Results: Key findings suggest that high cost of travel (>10 GHS) and whether a child was treated elsewhere before arriving to the hospital had the greatest odds of a child developing SM with an adjusted odds ratio of 8.23(95% CI: 1.82-37.21, p<0.01) and 3.36(95% CI: 0.84-13.49,p 0.08), respectively. A house with a corrugated roof was also found to be protective by 94.2% (95% CI:0.006-0.552, p<0.05), when adjusted for potential confounders.

Discussion: Although the study design and analysis have many limitations, this research suggests a linear association between lower socioeconomic position, delayed health-seeking and severe malaria incidence- confirming previous findings and emphasising the relevance of social drivers of malaria. More interventions need to be put in place to increase community outreach and accessibility for people from more deprived communities in Ghana.

Note:
Funding Information: This work was funded by The London School of Hygiene and Tropical Medicine.

Conflict of Interests: There is no known conflict of interest.

Ethical Approval: Ethical approval was sought and obtained from The London School of Hygiene and Tropical Medicine, The University of Health and Allied Sciences in Ghana and from the government of Ghana.

Keywords: malaria, sub-saharan Africa, Ghana, socioeconomic, severe malaria, child health, paediatrics, epidemiology