| dc.description.abstract |
Background and Aims: Malaria and anemia remain major public health challenges contributing substantially to morbidity
and mortality among children under 5 years in sub‐Saharan Africa (SSA). Although conventional regression analyses have
reported a significant association between malaria infection and anemia, these approaches often inadequately account for
socioeconomic and demographic confounders, thereby limiting causal interpretation. This study aimed to estimate the causal
effect of malaria infection on anemia among children under five in Uganda using a robust quasi‐experimental approach.
Methods: We conducted a Propensity Score Matched (PSM) analysis using data from the 2018–2019 Uganda Malaria Indicator
(Cross‐Sectional) Survey (UMIS). The study population comprised children under 5 years of age with complete data on malaria
status (exposure) and anemia status (outcome). A logistic regression model was used to estimate the propensity scores,
incorporating a comprehensive set of child‐level, maternal, and contextual covariates. The Average Treatment Effect on the
Treated (ATT) was estimated in Stata v14.0 using survey weights to account for the UMIS complex sampling design.
Result: The prevalence of malaria infection among children under five was 23.6% [95% CI: 19.8, 27.8], while the prevalence of
anaemia (mild, moderate, or severe) was 51.2% [95% CI: 48.3, 54.1]. The effect of exposure to malaria infection on anaemia was
positive and significant [Average Treatment Effect of the Treated (ATT) = 25.6%, 95% CI: 17.6%, 33.5%, p < 0.001]. These results
indicate that malaria infection increases the likelihood of anaemia by 25.5 percentage points among infected children under five
in Uganda, after adjusting for key confounders.
Conclusion: Malaria infection is a major driver of anaemia among Ugandan children under five. Strengthening malaria
prevention and prompt treatment could substantially reduce childhood anemia and its associated health burden. |
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