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

Julius Kwabena Karikari1,2, Kweku Bedu-Addo3, Yahye Sheikh Abdulle Hassan4

  • 1University Hospital, Kwame Nkrumah University of Science and Technology, P. O. Box PMB KNUST, Kumasi, Ghana. juliuskarikari@gmail.com.

BMC Pediatrics
|November 25, 2025
PubMed

Insights

The co-occurrence of malaria and anaemia affects 6.4% of Ghanaian children under five. Risk factors include fever and birth order, while household wealth and parental education play a role in this double burden.

Area of Science:

  • Public Health
  • Pediatrics
  • Tropical Medicine

Background:

  • Malaria and anaemia frequently co-occur in children under five, particularly in low- and middle-income countries.
  • This co-occurrence is a significant contributor to childhood morbidity and mortality globally.
  • Ghana faces a substantial public health challenge due to this double burden.

Purpose of the Study:

  • To estimate the prevalence of the co-occurrence of malaria and anaemia (double burden) in Ghanaian children under five.
  • To identify risk factors associated with this double burden.
  • To inform targeted public health interventions.

Main Methods:

  • Utilized data from the 2022 Ghana Demographic and Health Survey.
  • Employed mixed-effects multilevel binary logistic regression models to identify risk factors.
  • Illustrated regional prevalence variations using a choropleth map.

Main Results:

  • The prevalence of the double burden was 6.4% (95% CI: 5.5-7.5).
  • Associated factors included higher birth order, recent fever, and lower maternal education.
  • Children in wealthier households and those with older household heads showed reduced odds of the double burden.

Conclusions:

  • The double burden of malaria and anaemia remains a critical health issue for Ghanaian children under five.
  • While malaria prevalence may decrease, anaemia persists at high levels.
  • Integrated interventions focusing on malaria prevention, nutrition, and anaemia control are crucial, especially in high-burden areas.
Abstract

Keywords:
AnaemiaDemographic and health surveyDouble burdenGhanaMalaria

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