Ecological Conditions, Malaria Prevention and Under-Five Mortality in Uganda

Bob Elwange, Kyambogo University
Lorretta Favour C. Ntoimo, Federal University Oye-Ekiti

Background: Despite higher bed nets coverage in ecologically higher altitude and low malaria transmission areas in Uganda, malaria morbidity among under-five is higher in such areas and mortality also varies by altitude and malaria transmission level in Uganda. Objectives: Study the extent to which ecological factors affect under-five mortality; whether ecological factors modify the effects of malaria prevention on under-five mortality. Method: The study uses 2011 Uganda Demographic and Health Survey data and Cox proportional hazard model for analysis. Findings: Under-five mortality is lower in higher altitude areas but there was insignificant difference of 1.0% between low and high transmission areas ((p>0.05; CI: 0.88-1.16). Whereas malaria prophylaxis during pregnancy is associated with under-five mortality and the risk higher among women who administered the drug (HR=3.01; p<0.05), after adjusting for ecological factors, the strength of malaria prophylaxis weakens (HR=2.37; p<0.1). Recommendations: Policy makers must consider altitude as important in malaria prevention.