The unequal malaria burden attributable to child growth failure: a global analysis among children under five from...

Malaria remains a major global public health threat, and child growth failure (CGF) is a risk factor for malaria.

This study aimed to comprehensively assess the burden of malaria attributable to CGF in children under 5 years.

Using data from the 2021 Global Burden of Disease (GBD) study, we conducted a systematic analysis of the global, regional, and national malaria burden attributable to CGF from 1990 to 2021. Age-standardized mortality rates (ASMR) and age-standardized disability-adjusted life years rate (age-standardized DALY rate) were used as core indicators to calculate annual percentage change (APC) and average annual percentage change (AAPC), with stratified analyses conducted by sex, socio-demographic index (SDI), region, and country.

Globally, the malaria burden attributable to CGF significantly declined since 1990 (AAPC = -1.26; 95% CI: -1.36 to -1.17), but showed an upward trend after 2019 (APC = 3.66; 95% CI: 2.38 to 4.80). Substantial variations across sex, age, regions, and countries were observed. Specifically, higher burdens were observed in males (ASMR: 17.59 per 100,000), children aged 6-11 months (mortality rate: 31.63 per 100,000), and the West and Central Africa regions (ASMR: 88.09 per 100,000) and Niger (ASMR: 149.94 per 100,000). SDI showed a significant negative correlation with both CGF-related malaria ASMR and age-standardized DALY rate.

Although there is an overall decline in the CGF-related malaria burden, males and infants aged 6 to 11 months, along with low-SDI regions (particularly Western Sub-Saharan Africa and Nigeria), continues to bear a disproportionately high burden.