Nutrient Patterns and Their Associations with Clinical Malaria Among Children Aged 6-23 Months in Siaya County, Kenya: A Cross-sectional Analysis

Malaria remains a public health concern among young children in sub-Saharan Africa. Climate change may deplete essential nutrients in major food crops. The impacts of climate-sensitive nutrients on clinical malaria are yet to be established. This study aimed at identifying nutrient patterns and their cross-sectional associations with clinical malaria among young children living in rural Kenya. We used baseline data of a cluster-randomized controlled trial with 506 children aged 6-23 months, recruited within the Siaya Health and Demographic Surveillance System (HDSS) between August and December 2021. We performed physical examinations, malaria microscopy, medical history taking, and questionnaire-based interviews on socio-demographic and dietary variables. Nutrient patterns were derived by Principal Component Analysis (PCA) with orthogonal rotation. Multiple-adjusted logistic regression analyses were used to calculate odds ratios (OR), 95% confidence intervals (CIs), and p-values for the associations of nutrient patterns with clinical malaria (defined as Plasmodium spc. with fever (≥37.5°C) or a history of fever or prescribed anti-malaria medication) and anemia (Hb <11g/dL). In this study population (boys: 54%; mean age: 15.0 ± 5.0 months), 12% had clinical malaria and 73% had anemia. Two nutrient patterns were identified: The fibre- and micronutrient pattern explained 4% of the variation in nutrient intakes, and the fat- and protein pattern explained 2%. Stronger adherence to the fibre- and micronutrient pattern tended to increase the chance of clinical malaria (OR per 1 score-standard deviation increase: 2.18; 95% CI: 0.86, 5.56). There was no association of the fat- and protein pattern with clinical malaria, and both patterns were not associated with anemia. In conclusion, clinical malaria and anemia are common among young children in Siaya County, Kenya. On this background, enhanced availability of climate-sensitive micronutrients may increase their risk of clinical malaria.