Background Intermittent Preventive Treatment in infants (IPTi) is a strategy to prevent malaria in children living in moderate-to-high malaria transmission areas through administration of a full therapeutic course of sulfadoxine-pyrimethamine. MULTIPLY is a multicentric project aiming at implementing IPTi in three sub-Saharan Africa countries. Before IPTi implementation in Togo, we conducted a survey to estimate malaria and Plasmodium infection prevalence in children aged 10 to 23 months (U2).

Methods A cross-sectional household survey was conducted in Haho district between Jan- Feb (dry season) 2022. Three-stage cluster random selection was carried out. Vaccination status, insecticide-treated bed net use, and children’s demographic characteristics were collected. Malaria infection was defined as positive malaria rapid diagnostic test and estimated with its 95% confidence interval (CI). A mixed-effects logistic regression model was used to assess factors associated with malaria infection. Survey data was weighted to reflect the sampling design.

Results A total of 685 children (51.8% male) were included with a mean age of 17 months. Eight out of ten slept under bed net the night before the interview. The prevalence of Plasmodium infection was 32.1% (95% CI: 28.6–35.7) of which a half had clinical symptoms. In the multivariable model, low educational level of the household head (primary: aOR=1.78 and no formal education: aOR=1.70; p=0.038; ref = secondary or above), presence of more than one under five years children in the household (aOR=1.47; p=0.031) and living at >5 km from the nearest health facility (aOR=1.52; p=0.042) were associated with malaria infection.

Conclusion While the survey was conducted in the dry season, one third of U2 children had malaria infection. IPTi can be a promising strategy to reduce malaria burden in this vulnerable population. Strengthening outreach services and more targeted health communication could play an important role in protecting children against malaria.