Epidemiology and Risk Factors for Severe Malaria in Under-Five Children in Kano State, North West Nigeria: An Analytical Study

Severe malaria in children under five remains the leading cause of paediatric intensive care admissions and deaths in Nigerian hospitals, yet state-specific epidemiological data on risk determinants for disease progression from uncomplicated to severe malaria are insufficiently documented. This study investigates the epidemiology and risk factors for severe malaria in under-five children in Kano State, North West Nigeria. A case-control analytical design was employed at Aminu Kano Teaching Hospital and Murtala Mohammed Specialist Hospital, recruiting 150 cases of severe malaria defined by WHO criteria and 300 controls with uncomplicated malaria, matched by age and sex. Thick blood films, haematocrit, blood glucose, and rapid diagnostic tests were performed for all participants. Multivariate logistic regression was used to identify independent risk factors including nutritional status, anaemia severity, bednet use, treatment delay, caregiver education, and distance to health facility. Current literature from 2020 to 2024 identifies anaemia, wasting, delayed health-seeking, and incomplete vaccination as the strongest independent predictors of severe malaria progression in Nigerian under-fives. This study will generate a risk profile applicable for designing targeted severe malaria prevention strategies in Kano State. Findings will inform the Kano State Ministry of Health and the Aminu Kano Teaching Hospital paediatrics department on evidence-based clinical triage protocols. Keywords: severe malaria, under-five children, risk factors, Kano State, case-control study.