Household Water, Sanitation and Malaria Infection among Children Aged 6–59 Months in Kogi State, Nigeria: A Secondary Analysis of the 2015 Nigeria Malaria Indicator Survey

Malaria remains an important public health problem among young children in Nigeria, while household water and sanitation conditions may influence exposure to malaria transmission. This study assessed the relationship between household water, sanitation and malaria infection among children aged 6–59 months in Kogi State using secondary data from the 2015 Nigeria Malaria Indicator Survey. A cross-sectional analysis was conducted among 172 children with valid malaria rapid diagnostic test (RDT) results. Drinking-water source and sanitation facility were classified as improved or unimproved/no facility. Survey weights and the complex sampling design were incorporated using Taylor linearization. Weighted logistic regression was used to estimate adjusted odds ratios (aORs). The weighted prevalence of RDT-confirmed malaria was 26.2%. Unimproved/no sanitation was associated with higher odds of malaria (aOR 2.50, 95% CI 0.68–9.14), but the association was not statistically significant (p=0.140). Unimproved drinking-water source was not independently associated with malaria (aOR 0.74, 95% CI 0.19–2.88; p=0.611). Children aged 36–59 months had significantly higher odds of malaria than those aged 6–35 months (aOR 3.07, 95% CI 1.72–5.51; p=0.003). The findings indicate a substantial malaria burden among children in Kogi State and identify older preschool age as an important independent correlate. Although sanitation showed an elevated point estimate, the evidence was insufficient to establish an independent association after adjustment. Integrated malaria prevention and environmental-health interventions, together with larger Kogi-specific studies, are recommended.