Clinical and Demographic Factors Influencing Treatment Response in Paediatric Malaria with Severe Acute Malnutrition (SAM)
Musab Mahadi Abbas1*, Omer Saeed Magzoub2, Rasha Sidahmed Elhassn3
1Pediatric Specialist, Al Duwaym Teaching Hospital, Al Duwaym City, Sudan.
2Pediatric Specialist, Ain Al Khaleej Hospital, Al Ain, Abu Dhabi, UAE.
3Paediatrician, Assistant professor of pediatric, Ribat university, Sudan.
*Corresponding Author: Dr. Musab Mahadi Abbas, Pediatric Specialist, Al Duwaym Teaching Hospital, Al Duwaym City, Sudan.
https://doi.org/10.58624/SVOAPD.2026.05.008
Received: April 27, 2026
Published: May 18, 2026
Citation: Abbas MM, Magzoub OS, Elhassn RS. Clinical and Demographic Factors Influencing Treatment Response in Paediatric Malaria with Severe Acute Malnutrition (SAM). SVOA Paediatrics 2026, 5:3, 61-70. doi: 10.58624/SVOAPD.2026.05.008
Abstract
Background: Severe Acute Malnutrition (SAM) and malaria remain leading causes of morbidity and mortality among children in sub-Saharan Africa. When combined, these conditions interact synergistically to worsen clinical outcomes.
Objectives: This study sought to: Identify demographic and clinical predictors of therapeutic response in severely malnourished children diagnosed with malaria. 2. Compare the effectiveness of commonly used antimalarial treatment regimens in this high-risk population. 3. Assess whether different forms of malnutrition (wasting, oedema, or a combination of both) influence treatment outcomes.
Methods: A hospital-based cohort of 96 children aged 6 months to 3 years admitted with malaria and coexisting severe acute malnutrition was analysed. Nutritional status was classified as oedematous, wasted, or mixed (oedema and wasting). Demographic characteristics, clinical features, and treatment modalities were retrieved from clinical records. Associations with treatment outcomes were evaluated using chi-square tests; p<0.05 was considered statistically significant.
Results: The sample included slightly more males (52.1%) than females, and most children (91.7%) originated from rural areas. Mixed malnutrition was the most prevalent presentation (68.8%). Overall treatment success was high (95.8%), with significantly better outcomes observed among males (p = 0.049) and rural residents (97.7% vs. 75.0%, p = 0.034). Artemisinin-based therapies demonstrated superior effectiveness: Co-artem achieved a 100% response rate, and Artesunate yielded 97.1%, compared with 92.3% for Quinine. Notably, none of the children treated with Artemether showed a good therapeutic response (p<0.001). Clinical recovery was unaffected by mid-upper arm circumference or nutritional status category, with no statistically significant differences observed (p>0.05).
Conclusion: In this rural cohort of young children with severe acute malnutrition, artemisinin-based combination therapies, particularly artemether–lumefantrine, showed excellent efficacy, whereas artemether monotherapy failed. These findings underscore the urgent need to discontinue monotherapies and reinforce adherence to WHO treatment guidelines.
Keywords: Malaria, Severe Acute Malnutrition, Demographic Features, Treatment Outcomes.