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. AIM: 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. MATERIALS AND 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). CONCLUSION: 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.