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Cameroon is a hyperendemic country to malaria where it remainsa major public health concern, especially amongst children under-five.Insecticide-treated bednets (ITBNs) is the main control strategies. This studyaimed at determining the predictors of malaria prevalence and coverage ofITBNs among under-five children in the Buea Health District (BHD), SouthWest Region of Cameroon in other to reduce the morbidity and mortality ofmalaria. Methods: A cross-sectional study was carried out in the BHD whichis a malaria-hyperendemic area. Every head (female/male) of the householdwho was present at home at the time of data collection was randomly interviewedusing a structured questionnaire. Under-five children were ascertainedfor malaria using microscopy, with a temperature of ≥37.50°C. Results: Outof 391 children (mean age = 19.7 month, SD = 2.5) who were selected and ascertainedfor malaria, the overall malaria prevalence was 13.04% (95% CI:10.04 - 16.78). In a multivariate analysis after adjusting for confounders, femaleparents/guardians (AOR = 0.53, 95% CI: 0.29 - 0.91) was associated withlow risk of malaria while parents/guardians with no formal/primary educational(AOR = 3.3, 95% CI: 1.76 - 4.04) and children who did not use ITBN(AOR = 1.40, 95% CI: 1.08 - 2.51) were associated with an increased risk ofmalaria. Out of the selected children, 84.4% possessed ITBN (95% CI: 80.4 - 87.7) while 72.6% (95% CI: 67.9 - 76.8) used ITBN. In a multivariate after adjustingfor confounders, Bova health area showed a significantly lower usage ofITBNs (χ 2 = 14.053, p = 0.003). Conclusion: The findings indicate that increasedITBN usage, increased parents/guardians’ educational level and goodknowledge of ITBN is required to lower the risk of under-five children beinginfected with malaria. Health area of residence greatly influences the directrelationship between bednets possession and usage. These, therefore, indicatesthe possession of ITBN doesn’t mean their usage. The Cameroon National malariacontrol programs should consider the realities of the living conditions ofthe population for the implementation of better policies.

journal of biosciences and medicines

Predictors of Malaria Prevalence and Coverage of Insecticide-Treated Bednets among Under-Five Children in the Buea Health District, South West Region, Cameroon