ArticleTropical medicine & international health : TM & IH2026
Co-Occurrence of Malaria, Pneumonia, and Diarrheal Disease Among Households: A Cohort Study in Rural Western Uganda.
Article in Tropical medicine & international health : TM & IH, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesThis study aims to identify patterns associated with clustering and co-occurrence of malaria, pneumonia, and diarrhoea, the leading causes of death in children under age five in sub-Saharan Africa, in western Uganda to generate evidence for integrated prevention and control measures.
methodsWe conducted a prospective longitudinal study complemented by passive surveillance at local clinics. All households in the three selected villages were eligible to participate. Household-level socioeconomic and geographic data were linked to clinically diagnosed disease outcomes. Co-occurrence of diseases within households, defined as the diagnoses of two of the three diseases of interest (malaria, pneumonia, and diarrhoea) within a four-week period, was assessed using a Poisson model with a log link. Multinomial logistic regression models were fit to assess the association between patterns of malaria and pneumonia occurrence with socioeconomic and geographic factors.
resultsA total of 399 households were enrolled and completed baseline surveys. The smallest village accounted for 68.5%, 43.2%, and 38.1% of malaria, pneumonia, and diarrhoea cases, respectively. After adjusting for village, socioeconomic status, and the mean age of children in the home, households in Kasanzi had a higher relative risk of having both malaria and pneumonia versus neither disease compared to households in Bunyangoni (RRR: 33.84, 95% CI: 7.10, 161.24). For models replacing village with elevation, households in at higher elevations had a higher relative risk of having both malaria and pneumonia versus neither disease compared to households in at lower elevations (RRR: 26.59, 95% CI: 2.53, 279.84). No clear associations were found between malaria and pneumonia co-occurrence and SES.
conclusionsFindings demonstrate that within small geographic areas, disease burden can vary dramatically across communities. Targeted, community-level interventions, rather than broad regional programs, are essential to address the distinct transmission dynamics and overlapping risks faced by high-burden communities.
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