Malaria and Nutritional Status Among Under-Five Children in Imo State, South East Nigeria

The relationship between malaria parasitaemia and nutritional status in young children is bidirectional: malaria worsens nutritional outcomes through anorexia and nutrient malabsorption, while undernutrition impairs immune competence and increases malaria severity. This study examines the association between malaria infection and nutritional status among children under five in Imo State, South East Nigeria. A cross-sectional design was employed at three primary healthcare facilities in Owerri Municipal, Orlu, and Okigwe Local Government Areas, recruiting 310 children aged 6 to 59 months. Malaria diagnosis was performed by Giemsa-stained thick blood film microscopy, and nutritional status was assessed using weight-for-height Z-scores, weight-for-age Z-scores, and mid-upper arm circumference measurements calibrated against WHO child growth standards. Information on dietary diversity, breastfeeding duration, caregiving practices, and household food security were collected from mothers. Literature from 2020 to 2024 documents a synergistic interaction between malaria and undernutrition in southeastern Nigeria, with acutely malnourished children showing significantly higher parasite densities. This study aims to quantify the independent contribution of malaria to wasting and stunting and provide evidence for integrated nutrition-malaria programming. Findings will be shared with the Imo State Agency for the Control of AIDS, TB, Malaria, and other Diseases, and partner nutrition organisations operating in the state. Keywords: malaria, nutritional status, under-five children, Imo State, wasting.