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Dose-response relationships, Plasmodium species, and trimester-specific effects of malaria on stunting in Papua, Indonesia.

Created on 07 Aug 2026

Authors

Muhamad Sahiddin, I Rai Ngardita, Masrif, Budi Kristanto, Asrianto, Noor Faradillah Abdullah

Published in

Transactions of the Royal Society of Tropical Medicine and Hygiene. Aug 06, 2026. Epub Aug 06, 2026.

Abstract

Malaria and stunting are highly prevalent in Papua, Indonesia, yet their association remains poorly understood. We examined dose-response relationships between postnatal malaria and stunting, trimester-specific prenatal effects, effect modification by insecticide-treated net (ITN) use, and risk by Plasmodium species.
Unmatched case-control study of 1301 children 12-60 months (435 cases; 866 controls) from 25 primary health centres. Exposure was ascertained from health centre registers and maternal cohort records. Multivariable logistic regression with cluster-robust standard errors was used; ITN effect modification was assessed using an interaction term.
One postnatal malaria episode was associated with increased stunting odds [adjusted OR (aOR) 1.52; 95% CI 1.02-2.29], with a significant dose-response trend compared with no malaria exposure. Prenatal malaria was not significant after adjustment. Low birth weight was the strongest predictor (aOR 2.22; 95% CI 1.29-3.82). ITN use modified the malaria-stunting association (interaction aOR 0.37; 95% CI 0.18-0.73). Plasmodium falciparum was associated with increased stunting odds vs no prenatal malaria (OR 1.84; 95% CI 1.18-2.89).
Recurrent postnatal malaria is associated with stunting in a dose-response pattern, modified by ITN use. Findings support malaria control and nutrition programme integration in endemic settings.

PMID:
42561424
Bibliographic data and abstract were imported from PubMed on 07 Aug 2026.

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