Understanding Socio-Demographic, Environmental, and Behavioral Factors Associated with Malaria Infection Among Children Under Five Years in Tanzania: A Rapid Review
Abstract:
Malaria
is a global public health concern and remains one of the major causes of
morbidity and mortality among children under five in sub-Saharan Africa, with
Tanzania bearing a substantial share of the burden. Although multiple studies
have examined risk factors, evidence on socio-demographic, environmental, and
behavioral determinants remains fragmented. A comprehensive synthesis of this
evidence is critical to guide context-specific interventions. This rapid review synthesised studies
published between January 2021 and December 2025 to identify factors associated
with malaria infection among children under five. Data on study characteristics
and key findings were extracted systematically, verified, and synthesized
narratively. The results were organised into socio-demographic, environmental,
and behavioural determinant domains. Twenty-one studies met inclusion criteria.
Cross-sectional designs
predominated (n=8, 38%), followed by randomized trials (n=5, 24%). Most studies
were community-based (n=19, 91%) and focused either exclusively on children
under 5 (n=8, 38%) or on mixed-age groups (n=6, 29%).
Malaria infection
among children under five in Tanzania is consistently associated with child
age, maternal education, and household socio-economic status. Environmental
factors such as housing quality, sanitation, and proximity to mosquito breeding
sites, along with behavioral factors including ITN use, care-seeking, and
nighttime outdoor exposure, also influence risk. These determinants interact
within ecological and socio-economic contexts, underscoring the need for
integrated, context-specific interventions. Strengthening vector control,
improving housing and environmental conditions, promoting protective behaviors,
and addressing socio-economic inequities are key to reducing malaria. This
review provides evidence to guide targeted interventions and future research
for accelerating malaria control in Tanzania.
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