Incidence and risk factors for malaria, pneumonia and diarrhea in children under 5 in UNHCR refugee camps: A retrospective study

Table 2 Incidence rate ratios for malaria^a

	Malaria^b
	Unadjusted	Adjusted ^c
Camp Location & Size
Small (< 10,000)	Reference	Reference
Medium (10,000-19,999)	0.85 (0.56-1.28)	1.94 (0.69-5.46)
Large (≥20,000)	0.89 (0.55-1.45)	2.01 (0.57-7.13)
Africa^d	Reference	Reference
Asia	0.06 (0.04-0.10)	0.01 (0.001-0.13)
Water and Sanitation (reference category is below the specified standard) ^e
Water Quantity	1.33 (1.05-1.67)	1.11 (0.60-2.08)
Water Access	1.39 (0.82-2.35)	1.66 (0.76-3.65)
Water Proximity	2.34 (0.66-8.21)	0.99 (0.63-1.56)
Latrine Access	1.21 (0.67-2.19)	1.07 (0.74-1.53)
Latrine Coverage	1.20 (0.84-1.73)	0.87 (0.33-2.26)
Soap Access	0.87 (0.63-1.22)	N/A^f
Nutrition Standards (reference category is below the specified standard) ^e
Global Acute Malnutrition	1.29 (1.04-1.61)	1.73 (0.72-4.17)
Ration Adequacy	1.01 (0.80-1.28)	0.62 (0.25-1.56)
Health Service Utilization
New Visits (per 10 persons/month)	1.92 (1.23-3.01)	2.57 (1.48-4.48)
Growth Monitoring (%)^g	0.98 (0.97-0.99)	0.99 (0.98-1.01)
Prevention of Malaria in Pregnancy
Insecticide Treated Nets (ITNs)	0.60 (0.17-2.06)	0.74 (0.44-1.24)
Intermittent Preventive Treatment (IPTp)	0.94 (0.51-1.74)	1.12 (0.25-4.99)

^aBold indicates statistically significant results (p < 0.05)
^bThe analysis was restricted to camps having an annual average monthly malaria incidence rate of 4 or more cases/1000 population/month in a given year and at least 8 months of data in a given year
^cThe adjusted model included all of the variables shown.
^dAfrica includes Yemen
^eThe IRR compares meeting or exceeding the standard to falling below the standard. The reference categories for UNHCR performance standards and indicators are as follows: water quantity > 20 L/person/day; water access < 80 persons per tap; water proximity 100% within 200 m; latrine access ≤20 person per latrine; latrine coverage 100% of households; soap access ≥90% of households with > 250 g soap/person/month; global acute malnutrition prevalence < 10%; and average kCals per person per day ≥2100 (in 2007 the indicator was minimum kCals per person per day).
^fAccess to soap was only reported for 2008 and 2009. So as to not exclude the 2007 data, soap was not included in the adjusted model.
^gIRR for every 1% increase in growth monitoring utilization

ISSN: 1752-1505