Determinants of Plasmodium infection prevalence using microscopy and nested polymerase chain reaction (nPCR) among febrile children suspected of malaria in Northwest Ethiopia

Background Malaria in children remains a major public health problem in the global, especially in sub-Saharan Africa. WHO reported an annually declining burden of malaria in Ethiopia. Despite these, different parts of the country reported a contradictory result, and malaria remains to be the main cause of morbidity among children. However, Microscopic examination of peripheral blood smear produces reliable results. Therefore, the aim of this study was to compare the performance of microscopy and nested polymerase chain reaction (nPCR) to detect malaria suspected febrile children. Methods A health institution-based cross-sectional study was conducted in northwest Ethiopia. A total of 302 malaria suspected participants were included. The capillary blood sample was collected from each study subject for the confirmation of malaria and a questionnaire was used to collect associated risk factors. Data analysis using SPSS version 23, Chi-square and multivariate analysis were performed for the comparison of categorical variables and assessment of associated risk factors, respectively. 𝑃 values less than 0.05 were taken as statistically significant. R esults: The overall prevalence of malaria was 22.2% and 18.2% by microscopy and nested polymerase chain reaction (nPCR), respectively. In nPCR malaria was found in 19.2% of males and 17.3% of female study subjects while the highest prevalence (25.6%) was observed among the age group ≥ 5 years old. Children in the age group between 1–5 years old were approximately 6 times more likely to be affected by malaria. And children who had no habited of bed net usages at all times were 12 times more likely to be contracted with malaria. Conclusion This study revealed that malaria infection among children seeks emphasis and need to specify the bottlenecks of all universal health coverage and community health awareness. In addition, the study suggested the need for adequate professional training towards clinical management of malaria to support unbiased diagnosis and treatment of childhood malaria.