OBJECTIVES: Water, Sanitation and Hygiene practices are interdependent and usually grouped together. Poor water, sanitation and hygiene practices directly and indirectly impact human disease dynamics. This study was conducted from April 2017 to April 2018 to assess and appraise the impact of water, sanitation and hygiene practices on the dynamics of childhood malaria in Abia State.

METHODS: A total of 1,209 caregivers were interviewed using a structured questionnaire to ascertain the socio-demographic characteristics of caregivers, under-fives and their level of water, sanitation and hygiene practices. Furthermore, 1209 children under five years of age from each of the households were screened using community based diagnoses. Under-fives who had fever were further screened for malaria using rapid diagnostic tests. Additionally, parasitological methods were employed to compare the results from the screening tests.

RESULTS: Out of the 1,209 under-fives studied, 707 (58.5%) had malaria (RDT); 562 (46.5%) had malaria (microscopy); Water availability (average water per capita) was 37.9 liters per person per day; 517 (42.8%) used non-improved main sources of drinking water; 1054 (87.2%) practiced inadequate water treatment methods; and 798 (66.0%) did not have private toilets. Only 463 (41.9%) of toilet wastes went into septic tanks; and 585 (48.4%) had hand washing devices. Inferential analysis showed that water, sanitation and hygiene practices statistically significantly predicted the prevalence of childhood malaria as F(7, 1201) = 18.610, p = 0.000, r = 0.313; F(7, 1201) = 14.896, p = 0.000, r = 0.283; and F(6, 1202) = 29.466, p = 0.000, r = 0.358 respectively.

CONCLUSIONS: This study shows that the level of water, sanitation and hygiene practices is poor, and significantly related to the occurrence of childhood malaria. Thus, sanitation must be scaled up in childhood malaria control interventions, and community diagnoses should be combined with specific diagnoses to improve overall child health in Abia State, Nigeria.