{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T07:54:00Z","timestamp":1790927640823,"version":"4.1.0"},"reference-count":43,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Malaria and anemia remain major public health challenges contributing substantially to morbidity and mortality among children under 5 years in sub\u2010Saharan Africa (SSA). Although conventional regression analyses have reported a significant association between malaria infection and anemia, these approaches often inadequately account for socioeconomic and demographic confounders, thereby limiting causal interpretation. This study aimed to estimate the causal effect of malaria infection on anemia among children under five in Uganda using a robust quasi\u2010experimental approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a Propensity Score Matched (PSM) analysis using data from the 2018\u20132019 Uganda Malaria Indicator (Cross\u2010Sectional) Survey (UMIS). The study population comprised children under 5 years of age with complete data on malaria status (exposure) and anemia status (outcome). A logistic regression model was used to estimate the propensity scores, incorporating a comprehensive set of child\u2010level, maternal, and contextual covariates. The Average Treatment Effect on the Treated (ATT) was estimated in Stata v14.0 using survey weights to account for the UMIS complex sampling design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>\n                      The prevalence of malaria infection among children under five was 23.6% [95% CI: 19.8, 27.8], while the prevalence of anaemia (mild, moderate, or severe) was 51.2% [95% CI: 48.3, 54.1]. The effect of exposure to malaria infection on anaemia was positive and significant [Average Treatment Effect of the Treated (ATT)\u2009=\u200925.6%, 95% CI: 17.6%, 33.5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001]. These results indicate that malaria infection increases the likelihood of anaemia by 25.5 percentage points among infected children under five in Uganda, after adjusting for key confounders.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Malaria infection is a major driver of anaemia among Ugandan children under five. Strengthening malaria prevention and prompt treatment could substantially reduce childhood anemia and its associated health burden.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.73001","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T04:54:05Z","timestamp":1785992045000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Estimating Causal Effects of Malaria Infection on Anaemia Among Children Under Five Years in Uganda: Evidence From a Cross\u2010Sectional Malaria Indicator Survey"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4421-5356","authenticated-orcid":false,"given":"Edson","family":"Mwebesa","sequence":"first","affiliation":[{"name":"Muni University, Faculty of Science Arua Uganda"},{"name":"School of Science and Aerospace Studies Moi University Eldoret Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1876-8419","authenticated-orcid":false,"given":"Delight Mawufemor","family":"Agbi","sequence":"additional","affiliation":[{"name":"School of Science and Aerospace Studies Moi University Eldoret Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3740-8865","authenticated-orcid":false,"given":"Lameck Ondieki","family":"Agasa","sequence":"additional","affiliation":[{"name":"School of Science and Aerospace Studies Moi University Eldoret Kenya"},{"name":"School of Health Sciences Kisii University Kisii Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Awor","sequence":"additional","affiliation":[{"name":"World Bank Development Research Group Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1788-2285","authenticated-orcid":false,"given":"Herbert Tafadzwa","family":"Kazonda","sequence":"additional","affiliation":[{"name":"Department of Environmental Health Masvingo Polytechnic Masvingo Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3885-1761","authenticated-orcid":false,"given":"Abraham Isiaka","family":"Jimmy","sequence":"additional","affiliation":[{"name":"School of Science and Aerospace Studies Moi University Eldoret Kenya"},{"name":"Department of Public Health University of Makeni Makeni Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7306-9962","authenticated-orcid":false,"given":"Scholastique M.","family":"Merveille Essetcheou","sequence":"additional","affiliation":[{"name":"Laboratoire de Biomath\u00e9matiques et d'Estimations Foresti\u00e8res Universit\u00e9 d'Abomey\u2010Calavi Cotonou B\u00e9nin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac Kipkosgei","family":"Tum","sequence":"additional","affiliation":[{"name":"School of Science and Aerospace Studies Moi University Eldoret Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory Kibet","family":"Kerich","sequence":"additional","affiliation":[{"name":"School of Science and Aerospace Studies Moi University Eldoret Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5279-8622","authenticated-orcid":false,"given":"Ann","family":"Mwangi","sequence":"additional","affiliation":[{"name":"School of Science and Aerospace Studies Moi University Eldoret Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40001\u2010023\u201001046\u20101"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.51745\/najfnr.4.8.285\u2010291"},{"key":"e_1_2_14_4_1","unstructured":"World Health Organization World Malaria Report 2024: Addressing Inequity in the Global Malaria Response[Internet]. Geneva: World Health Organization; 2024 [cited 2026 Feb 6]. Available from:https:\/\/iris.who.int\/handle\/10665\/379751."},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.4137\/VRT.S12248"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352\u20103026(23)00160\u20106"},{"key":"e_1_2_14_7_1","unstructured":"World Health Organization (WHO) Haemoglobin Concentrations for the Diagnosis of Anaemia and Assessment of Severity. Vitamin and Mineral Nutrition Information System [Internet]. World Health Organization Geneva; 2011 [cited 2026 Feb 15]. Available from:http:\/\/www.who.int\/vmnis\/indicators\/haemoglobin.pdf."},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/5725634"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.1009865"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12936\u2010018\u20102509\u20109"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amsu.2022.104366"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s44197\u2010024\u201000228\u20102"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12936\u2010023\u201004799\u20106"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12936\u2010025\u201005262\u20104"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12936\u2010024\u201005218\u20100"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12936\u2010025\u201005281\u20101"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0082455"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467\u2010023\u201041275\u2010w"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874\u2010025\u201002481\u2010w"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0145282"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12936\u2010025\u201005629\u20107"},{"key":"e_1_2_14_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12936\u2010026\u201005806\u20102"},{"key":"e_1_2_14_23_1","unstructured":"Uganda National Malaria Control Division (NMCD) Uganda Bureau of Statistics (UBOS) and ICF. Uganda Malaria Indicator Survey 2018\u201319. [Internet]. 2020 [cited 2026 Jan 18]. Available from:https:\/\/www.dhsprogram.com\/pubs\/pdf\/MIS34\/MIS34.pdf."},{"key":"e_1_2_14_24_1","doi-asserted-by":"publisher","DOI":"10.1080\/00273171.2011.568786"},{"key":"e_1_2_14_25_1","doi-asserted-by":"publisher","DOI":"10.1214\/09\u2010STS313"},{"key":"e_1_2_14_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12936\u2010024\u201005083\u2010x"},{"key":"e_1_2_14_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475\u20106773.12182"},{"key":"e_1_2_14_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475\u20106773.12182"},{"key":"e_1_2_14_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.2333\u20108504.1972.tb00631.x"},{"key":"e_1_2_14_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.14640"},{"key":"e_1_2_14_31_1","first-page":"137","volume-title":"Malaria Microscopy Quality Assurance Manual\u2014Version 2","author":"World Health Organization,","year":"2016"},{"key":"e_1_2_14_32_1","volume-title":"Guideline on Haemoglobin Cutoffs to Define Anaemia in Individuals and Populations"},{"key":"e_1_2_14_33_1","doi-asserted-by":"publisher","DOI":"10.21203\/rs.3.rs\u20102659455\/v1.Addis"},{"key":"e_1_2_14_34_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12936\u2010021\u201003948\u2010z"},{"key":"e_1_2_14_35_1","doi-asserted-by":"publisher","DOI":"10.1186\/1741\u20107015\u20106\u201024"},{"key":"e_1_2_14_36_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2025.1618395"},{"key":"e_1_2_14_37_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0260785"},{"key":"e_1_2_14_38_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12887\u2010022\u201003694\u20104"},{"key":"e_1_2_14_39_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41043\u2010020\u201000217\u20108"},{"key":"e_1_2_14_40_1","doi-asserted-by":"publisher","DOI":"10.4103\/0972\u20109062.353251"},{"key":"e_1_2_14_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.actatropica.2011.03.004"},{"key":"e_1_2_14_42_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879\u2010021\u201006929\u20104"},{"key":"e_1_2_14_43_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12936\u2010016\u20101266\u2010x"},{"key":"e_1_2_14_44_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaf712"}],"container-title":["Health Science Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hsr2.73001","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hsr2.73001","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hsr2.73001","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T07:10:39Z","timestamp":1790925039000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hsr2.73001"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":43,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/hsr2.73001"],"URL":"https:\/\/doi.org\/10.1002\/hsr2.73001","archive":["Portico"],"relation":{},"ISSN":["2398-8835","2398-8835"],"issn-type":[{"value":"2398-8835","type":"print"},{"value":"2398-8835","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]},"assertion":[{"value":"2026-03-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-31","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e73001"}}