Abstract
Malaria and undernutrition have independently contributed to mortality and morbidity among the under-five population of Nigeria. However, there remains complexity in their association. This study evaluates the association between stunting, underweight, wasting, and malaria among under-five Nigerian children while assessing the effects of sociodemographic factors. Cross-sectional data from the 2018 Nigeria Demographic and Health Survey were used, which included a study population of 12,996 children aged 0-59 months. Stunting (HAZ<-2.0 SD), underweight (WAZ<-2.0 SD), wasting (WHZ<-2.0 SD), malaria test results, and sociodemographic factors were obtained and examined. Logistic regression modeling was used to determine the associations between undernutrition, malaria, and sociodemographic factors. The prevalence of stunting was 37.0%, with 22.0% underweight, 6.9% wasting, and 22.6% tested positive for malaria. Stunting was frequent among 24-35 months old, 12-23 months old were mostly underweight and wasted, and 48-59 months old frequently suffered from malaria. Undernutrition and malaria frequently occurred among males, residents of rural areas, the poorest wealth quintile, and children of mothers with no formal education. The odds of having malaria was 89% higher among under-five stunted children (AOR = 1.89, 95% CI = 1.00,1.40; p-value = <0.0001). However, underweight (AOR = 1.11, 95% CI = 0.91,1.36; p-value = 0.2982) and wasting (AOR = 0.89, 95% CI = 0.67,1.19; p-value = 0.4519) were not significantly associated with malaria. The development of appropriate strategies, especially in rural areas and for less-educated mothers are critical to combat undernutrition and malaria.