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. Recurrent episodes of malaria have significant consequences for both children and their families. However, there remains a deficiency in knowledge regarding recurrent malaria episodes in Uganda.

Objective To determine 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 254 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 associated with recurrent malaria episodes were; children from houses that were annually sprayed (aOR; 8.93, 95CI%,2.11-37.81), 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, 2.21-31.27).

Conclusion Nearly 90% of children under the age of five years experienced recurrent malaria episodes. These recurrent infections were more frequent among children from houses that were annually sprayed and those from houses with delayed window closure compared to those who had been treated using quinine-based antimalarials. While quinine-based antimalarials remain an important treatment option, alternative or complementary malaria prevention strategies, such as frequent indoor spraying and early closure of windows should be prioritized.

The authors have declared no competing interest.

The author(s) received no specific funding for this work.

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethical approval to conduct the study was obtained from the Lira University Research Ethics Committee and approval was issued under rec number LUREC-2023-66. Written informed consent was sought from all the participants

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Data cannot publicly be shared because of fear of data misuse or replication without giving proper credit. Contact the corresponding author via email at tommurungi1999gmail.com to get a copy of the data files