Malaria and Helminth Co‑Infections and Their Association with Nutritional Status Among Children Under Five in a Rural District of Tanzania

Abstract

Background: Malaria and helminth infections are significant public health concerns in sub-Saharan Africa, particularly among children under five years, due to their contribution to anaemia and malnutrition. Understanding the interplay between parasitic infections, nutritional status, and feeding practices is essential for designing effective interventions. This study aimed to determine the prevalence of malaria, helminth infections (including schistosomiasis), anaemia, and malnutrition, and and to examine their associations with nutritional status among children under five years in Mbarali District, Tanzania.

Methods: A community-based cross-sectional study was conducted among 183 children aged 6–59 months. Sociodemographic data, feeding practices, and health history were collected using structured questionnaires. Anthropometric measurements, including mid-upper arm circumference (MUAC), were used to assess nutritional status. Malaria infection was diagnosed by Giemsa-stained thick and thin blood smear microscopy, while helminth infections were identified through stool and urine microscopy. Associations between infection status, nutritional status, and meal frequency were assessed using Pearson’s chi-square and Fisher’s exact tests, with significance set at p < 0.05.

Results: Malaria prevalence was 10.4% (n = 19), helminth infections affected 36.1% (n = 66), and co-infections were observed in 4.6% (n = 5) of children. Anaemia was detected in 9.8% of participants. Nutritional assessment revealed 81.97% had normal status, while 18.0% were malnourished or at risk. Significant associations were observed between malaria (χ² = 21.81, p < 0.001), helminth infections (χ² = 13.06, p = 0.004), co-infections (χ² = 11.45, p = 0.009), and poor nutritional status. Meal frequency was also significantly associated with nutritional status, with children consuming ≤3 meals/day more frequently classified as at risk of undernutrition or acute malnutrition.

Conclusion: Malaria prevalence was low, whereas helminth infections and undernutrition remain substantial challenges among children under five in Mbarali District. Malaria, helminth infections, and inadequate meal frequency were significantly associated with nutritional status among children under five years. Integrated public health strategies combining infection control, nutrition education, and promotion of adequate feeding practices are critical to improving child health in this rural setting.