Abstract
BACKGROUND: Malaria poses a substantial global challenge and continues to be a major cause of mortality and morbidity in numerous developing nations. Children under the age of five in low- and middle-income countries such as Uganda are the most affected. However, there remains a deficiency in knowledge regarding recurrent malaria episodes in Uganda. We determined the prevalence and factors associated with recurrent malaria episodes among children under five at Kayunga Regional Referral Hospital. METHODOLOGY: This was a cross-sectional study conducted among children under five at Kayunga Regional Referral Hospital in central Uganda. The data was collected among 250 consecutively sampled participants who were caring for children under five. Data was collected using a researcher-administered questionnaire and analyzed at univariate, bivariate, and multivariate levels. RESULTS: A total of 250 participants participated in the study with a response rate of 98.45%. The prevalence of recurrent malaria episodes was 84% (210). The factors significantly associated with recurrent malaria episodes were; children from houses that were annually sprayed (aOR; 8.93, 95%CI,2.11-37.81), children from houses that were not sprayed (aOR; 3.80,95%CI,1.27-9.41, p = 0.017), children who were treated with quinine antimalarial in the previous infection (aOR, 0.28, 95%CI,0.12-0.65) and children who were residing in a house whose windows were closed at 7-8 pm (aOR, 8.31, 95%CI, 2.21-10.27). CONCLUSION: The recurrence of malaria episodes among children under five is significantly high, suggesting the possibility of malaria resistance. Importantly, quinine remains a robust alternative treatment for complicated malaria, owing to its significant efficacy against malaria parasites in regions of moderate to high transmission rates. Malaria prevention programs should consider biannual indoor residual spraying in high malaria transmission areas using vector-susceptible insecticides.