Severe malaria readmissions in Northern Uganda : a cross‑sectional study.
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Date
2025
Authors
Olum, James
Mukunya, David
Nambozo, Brendah
Nantale, Ritah
Oguttu, Faith
Epuitai, Joshua
Lume, Ivan
Wanume, Benon
Olupot‑Olupot, Peter
Amanya, Daphine
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Publisher
Malaria Journal
Abstract
Background: Malaria is a critical global health issue, particularly for children in endemic regions. However, factors associated with recurrent severe malaria in children under 5 years of age in Northern Uganda are poorly understood. This study aimed to identify factors associated with readmission due to severe malaria within six months post-discharge among children in this age group.
Methods: A cross-sectional study was conducted in Otuke district, encompassing twelve health facilities. A total of 760 caregivers of children admitted with severe malaria were interviewed, and hospital records were reviewed to verify the readmission data. The primary outcome assessed was readmission with severe malaria within six months after initial discharge. Data analysis was performed via Stata version 15.0.
Results: The prevalence of readmission with severe malaria among children under 5 years of age was 26.8% (198/739). Factors significantly associated with readmission included having sickle cell anaemia [adjusted prevalence ratio (aPR) 1.72; 95% confidence interval (CI) (1.95–3.14)], living in houses constructed with straw and thatch walls [(aPR 2.10; 95% CI (1.19–3.69)] and seeking care after 12 h when the child has a fever [aPR 2.01; 95% CI (1.23–3.29)].
Conclusion: The findings indicate a high proportion of severe malaria readmissions in children under 5 years of age. Sickle cell anaemia, living in houses built using straw and thatch walls and seeking care after 12 h when a child has fever were the key risk factors for readmission with severe malaria. This study highlights the importance of targeted post-discharge interventions, such as prophylactic anti malarials in addition to bed nets, to prevent recurrent
infections especially among children with sickle cell disease. In addition, improvements in housing quality and timely
treatment of children with malaria are essential for reducing the burden of malaria, particularly in endemic regions.
Keywords Children under 5 years of age, Readmission, Associated factors, Severe malaria, Children, Uganda
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Research article
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Citation
Olum, J., Mukunya, D., Nambozo, B., Nantale, R., Oguttu, F., Epuitai, J., Lume, I., Wanume, B., Olupot-Olupot, P., Amanya, D., & Kakuru, A. (2025). Severe malaria readmissions in Northern Uganda: a cross-sectional study. Malaria Journal, 24(1), 64. https://doi.org/10.1186/s12936-025-05307-8