Association between malaria infection and anemia among Ugandan children aged 6-59 months A secondary analysis of Uganda Malaria Indicator Survey 2018-19

Sammanfattning

Background: Malaria and anemia remain common comorbid conditions among Ugandan children under five. However, recent nationally representative evidence describing the relationship between malaria infection and anemia is limited, creating a need for updated survey-based analysis to inform targeted prevention and control efforts. Methods: A survey‑weighted cross-sectional analysis of nationally representative data (2018-19 Uganda Malaria Indicator Survey) was conducted, including 5650 children aged 6-59 months with complete hemoglobin and malaria rapid diagnostic test results. Anemia was defined as altitude‑adjusted hemoglobin <11.0 g/dL and malaria infection as RDT positivity. Weighted prevalences, cross tabulation using Chi-square and multivariable logistic regression produced adjusted odds ratios and 95% confidence intervals for anemia in relation to malaria and selected sociodemographic covariates. Results: 51.8% of children were anemic and 19.6% were RDT‑positive for malaria. Anemia prevalence was higher among malaria‑infected than uninfected children (72.7%, 46.7% respectively). In adjusted models, malaria infection remained strongly associated with anemia (aOR 3.73, 95% CI 3.17-4.39). Younger age, male sex, low maternal education and household poverty were independently associated with higher odds of anemia, whereas higher maternal education and wealth were protective; the crude rural/urban difference in anemia was largely explained by these factors. Conclusion: Anemia remains highly prevalent among Ugandan children 6-59 months and is strongly and independently associated with current malaria infection. Integrated strategies that combine malaria control with nutrition interventions and broader investments in education and poverty reduction, particularly targeting the first two years of life, are needed to reduce childhood anemia.