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Background <p>Malaria remains a leading cause of morbidity and mortality among children under five in Uganda. Despite national control efforts, significant disparities and inequalities in prevalence persist across regions, residences, and mean socio-economic status. This study examines the socio-demographic factors and wealth-related inequalities associated with malaria among children under five in Uganda.</p> Methodology <p>A secondary analysis of data from the Uganda Malaria Indicator Survey (UMIS) 2018–2019 was conducted. A sample of 4,600 children with malaria test results was included in the study. The distribution of malaria prevalence across socio-demographic factors was analysed using cross-tabulations and a chi-squared test. Malaria-related inequalities were measured using equity plots and the concentration index (CIX). A multilevel logistic regression model was used to examine the relationship between malaria prevalence and associated factors. The results are presented as adjusted odds ratios (a<i>OR</i>s) with 95% confidence intervals (<i>CI</i>).</p> Results <p>Almost twenty-three in every 100 children under five had malaria infection (95%<i> C</i><i>I:</i> 19.2–27.0). Regional variations in malaria prevalence and wealth-related inequalities were observed. The multilevel model identified several significant independent factors: older child age (a<i>OR</i> = 2.12, 95% <i>CI:</i> 1.51–2.96, <i>P</i> &lt; 0.001), child’s anemia (a<i>OR </i>= 3.16, 95% <i>CI:</i> 2.33–4.29, <i>P</i> &lt; 0.001), and larger household size (a<i>OR</i> = 1.98, 95% <i>CI</i>: 1.13–3.45, <i>P</i> &lt; 0.05) were positively associated with malaria in children under five years in Uganda. A negative concentration index (CIX = −&#xa0;0.334, <i>P</i> &lt; 0.001) was also observed, indicating that higher malaria prevalence is concentrated among children in the poorest wealth quintile.</p> Conclusion <p>Malaria prevalence in Uganda is associated with a complex interplay of socioeconomic and geographic factors. The substantial disparities observed highlight the need for tailored public health strategies designed for high-burden regions and vulnerable communities to reduce disease burden effectively.</p>

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Prevalence, determinants, and wealth-related inequalities in malaria among under five children in Uganda: evidence from the malaria indicator survey

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月20日

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  • Edson Mwebesa,
  • Delight Mawufemor Agbi,
  • Isaac Isiko,
  • Gideon Ikemdinachi Nwankwo,
  • Rejoice Uche Obiora,
  • Bisola Folusho Olubiyi,
  • Charles Natuhamya

摘要

Background

Malaria remains a leading cause of morbidity and mortality among children under five in Uganda. Despite national control efforts, significant disparities and inequalities in prevalence persist across regions, residences, and mean socio-economic status. This study examines the socio-demographic factors and wealth-related inequalities associated with malaria among children under five in Uganda.

Methodology

A secondary analysis of data from the Uganda Malaria Indicator Survey (UMIS) 2018–2019 was conducted. A sample of 4,600 children with malaria test results was included in the study. The distribution of malaria prevalence across socio-demographic factors was analysed using cross-tabulations and a chi-squared test. Malaria-related inequalities were measured using equity plots and the concentration index (CIX). A multilevel logistic regression model was used to examine the relationship between malaria prevalence and associated factors. The results are presented as adjusted odds ratios (aORs) with 95% confidence intervals (CI).

Results

Almost twenty-three in every 100 children under five had malaria infection (95% CI: 19.2–27.0). Regional variations in malaria prevalence and wealth-related inequalities were observed. The multilevel model identified several significant independent factors: older child age (aOR = 2.12, 95% CI: 1.51–2.96, P < 0.001), child’s anemia (aOR = 3.16, 95% CI: 2.33–4.29, P < 0.001), and larger household size (aOR = 1.98, 95% CI: 1.13–3.45, P < 0.05) were positively associated with malaria in children under five years in Uganda. A negative concentration index (CIX = − 0.334, P < 0.001) was also observed, indicating that higher malaria prevalence is concentrated among children in the poorest wealth quintile.

Conclusion

Malaria prevalence in Uganda is associated with a complex interplay of socioeconomic and geographic factors. The substantial disparities observed highlight the need for tailored public health strategies designed for high-burden regions and vulnerable communities to reduce disease burden effectively.