In MalariaWorld this week there is reference to a publication preprint in BMC Pediatrics ‘The double burden: co-occurrence of malaria and anaemia in children under five in Ghana – a multilevel mixed-effects logistic regression analysis’ by Karikari et al. The study utilised data from the 2022 Ghana Demographic and Health Survey to assess the co-occurrence of malaria and anaemia in young children and found a significant number (6.4%) with the double burden of both conditions.
What is most notable is how serious a public health burden anaemia is – 49% of children under five in Ghana in the survey were found to be anaemic. Malaria was detected by microscopy in 8.1%. It is quite clear that the majority of these are also anaemic, those to whom the authors refer as double burdened.
It is quite clear from other results of the survey that this double burden is linked to poverty with the poorest households most likely to experience the double burden. However, this study and other studies report that prevalence of anaemia in Ghana and other African nations often exceeds 50% for this age cohort, e.g. 70.8% in Liberia and 72.9% in Mozambique. This clearly includes many more than the poorest children.
While the authors report that malaria occurrence has been falling it still seems to be linked to malnutrition. They recommend that anaemia be treated as a significant public health priority. They recommend interventions such as iron-folic acid supplementation, routine deworming, nutrition counselling, and screening for haemoglobinopathies.
It seems very clear from this and other studies that prioritizing improvements in nutrition for under fives other age groups is key to improving overall health. This will inevitably reduce and eventually eliminate the burden of malaria. I agree with the authors’ recommendation of education on basic nutrition.
Support to help people, especially the poorest, to obtain and eat better food is required most of all. Perhaps more people could be encouraged to raise chickens for eggs and meat. Such programs would have far more beneficial effects than the current medical intervention approach to malaria and other ailments of poverty and malnutrition.