Malaria remains a major global public health threat, and child growth failure (CGF) is a risk factor for malaria. This study aimed to comprehensively assess the burden of malaria attributable to CGF in children under 5 years. Using data from the 2021 Global Burden of Disease (GBD) study, we conducted a systematic analysis of the global, regional, and national malaria burden attributable to CGF from 1990 to 2021. Age-standardized mortality rates (ASMR) and age-standardized disability-adjusted life years rate (age-standardized DALY rate) were used as core indicators to calculate annual percentage change (APC) and average annual percentage change (AAPC), with stratified analyses conducted by sex, socio-demographic index (SDI), region, and country. Globally, the malaria burden attributable to CGF significantly declined since 1990 (AAPC = -1.26; 95% CI: -1.36 to -1.17), but showed an upward trend after 2019 (APC = 3.66; 95% CI: 2.38 to 4.80). Substantial variations across sex, age, regions, and countries were observed. Specifically, higher burdens were observed in males (ASMR: 17.59 per 100,000), children aged 6-11 months (mortality rate: 31.63 per 100,000), and the West and Central Africa regions (ASMR: 88.09 per 100,000) and Niger (ASMR: 149.94 per 100,000). SDI showed a significant negative correlation with both CGF-related malaria ASMR and age-standardized DALY rate. Although there is an overall decline in the CGF-related malaria burden, males and infants aged 6 to 11 months, along with low-SDI regions (particularly Western Sub-Saharan Africa and Nigeria), continues to bear a disproportionately high burden. • Global Decline with Recent Reversal: The CGF-attributable malaria burden declined from 1990–2019 (AAPC = –1.26%) but increased post-2019 (APC = +3.66%), reversing prior gains. • High-Risk Subgroups: Males (ASMR: 17.59/100,000) and infants aged 6-11 months (mortality rate: 31.63/100,000) face the highest mortality risk. • Regional Hotspots: The heaviest burden is concentrated in Sub-Saharan Africa, particularly Niger (ASMR: 149.94/100,000; ASDR: 13,288/100,000 in 2021). • Strong Socioeconomic Gradient: A significant inverse correlation exists between SDI and malaria burden. The malaria burden in low-SDI regions is more than 80 times higher than in high-SDI regions. • Policy Urgency: Integrated nutrition and malaria control strategies are urgently needed in high-burden regions to break the “infection-malnutrition” cycle.
Deng et al. (Sun,) studied this question.