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Introduction <p>Malaria and anaemia frequently co-occur among children under five globally, especially in low- and middle-income countries where both conditions are endemic. This co-occurrence significantly contributes to childhood morbidity and mortality, posing a major public health challenge. This study seeks to estimate the prevalence and identify the risk factors associated with the co-occurrence of malaria and anaemia (double burden) among children under five in Ghana.</p> Methods <p>The study utilised data from the 2022 Ghana Demographic and Health Survey. Regional variations in the prevalence of the double burden were illustrated using a choropleth map. To identify factors associated with the double burden, mixed-effects multilevel binary logistic regression models were employed using a four-model approach. Findings were reported as adjusted odds ratios (aOR) with corresponding 95% confidence intervals (CI) and intra-class correlation coefficients. Analyses were conducted using Stata/SE Version 17, incorporating sampling weights, with statistical significance set at <i>p</i> &lt; 0.05.</p> Results <p>The prevalence of the double burden of malaria and anaemia among children under five in Ghana was 6.4% [95% CI: 5.5–7.5]. Double burden was associated with fifth-born children [aOR = 3.92; 95% CI: 1.60–9.62], children who had fever within the two weeks preceding the survey [aOR = 2.49; 95% CI: 1.46–4.24], children whose mothers had attained primary education [aOR = 1.87; 95% CI: 1.07–3.28], children living in households headed by individuals aged 60 years or above [aOR = 0.33; 95% CI: 0.14–0.79], children from poorer [aOR = 0.51; 95% CI: 0.29–0.90], middle-income [aOR = 0.31; 95% CI: 0.13–0.74], and richer [aOR = 0.31; 95% CI: 0.12–0.80] households.</p> Conclusion <p>The co-occurrence of malaria and anaemia remains a major health concern among Ghanaian children under five. Despite reduced malaria prevalence, anaemia persists at high levels. Integrated interventions that combine malaria prevention, nutrition improvement, and anaemia control, particularly in high-burden regions, are essential for enhancing child health outcomes.</p> Clinical trial number <p>Not applicable.</p>

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The double burden: co-occurrence of malaria and anaemia in children under five in Ghana – a multilevel mixed-effects logistic regression analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月24日

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  • Julius Kwabena Karikari,
  • Kweku Bedu-Addo,
  • Yahye Sheikh Abdulle Hassan,
  • Emmanuel Konadu,
  • Mercy Addae,
  • Obed Kwabena Offe Amponsah,
  • Douglas Aninng Opoku

摘要

Introduction

Malaria and anaemia frequently co-occur among children under five globally, especially in low- and middle-income countries where both conditions are endemic. This co-occurrence significantly contributes to childhood morbidity and mortality, posing a major public health challenge. This study seeks to estimate the prevalence and identify the risk factors associated with the co-occurrence of malaria and anaemia (double burden) among children under five in Ghana.

Methods

The study utilised data from the 2022 Ghana Demographic and Health Survey. Regional variations in the prevalence of the double burden were illustrated using a choropleth map. To identify factors associated with the double burden, mixed-effects multilevel binary logistic regression models were employed using a four-model approach. Findings were reported as adjusted odds ratios (aOR) with corresponding 95% confidence intervals (CI) and intra-class correlation coefficients. Analyses were conducted using Stata/SE Version 17, incorporating sampling weights, with statistical significance set at p < 0.05.

Results

The prevalence of the double burden of malaria and anaemia among children under five in Ghana was 6.4% [95% CI: 5.5–7.5]. Double burden was associated with fifth-born children [aOR = 3.92; 95% CI: 1.60–9.62], children who had fever within the two weeks preceding the survey [aOR = 2.49; 95% CI: 1.46–4.24], children whose mothers had attained primary education [aOR = 1.87; 95% CI: 1.07–3.28], children living in households headed by individuals aged 60 years or above [aOR = 0.33; 95% CI: 0.14–0.79], children from poorer [aOR = 0.51; 95% CI: 0.29–0.90], middle-income [aOR = 0.31; 95% CI: 0.13–0.74], and richer [aOR = 0.31; 95% CI: 0.12–0.80] households.

Conclusion

The co-occurrence of malaria and anaemia remains a major health concern among Ghanaian children under five. Despite reduced malaria prevalence, anaemia persists at high levels. Integrated interventions that combine malaria prevention, nutrition improvement, and anaemia control, particularly in high-burden regions, are essential for enhancing child health outcomes.

Clinical trial number

Not applicable.