Published in PLOS One on 2026-06-25, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. HealthSignal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Halid Worku Jemil, Sonia Worku Semayneh, Eyob Tilahun Abeje, Altaseb Beyene Kassaw, Gosa Mankelkl, Anmut Endalkachew Bezie, Adisu Meles Kabtyimer
Source: PLOS One • DOI 10.1371/journal.pone.0351864
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
coexistence of anemia and undernutrition is a major public health concern among children in Mali. However, there is a lack of study looking into the relationship between undernutrition and anemia among children in Mali. Therefore, this study was conducted by using multilevel analysis to identify significant factors associated with the coexistence of anemia and undernutrition among children.
A cross-sectional design was conducted from Mali Demographic and Health Survey data from 2023/24. STATA 17 was used for data summarization and analysis. The model was evaluated using the intra-class correlation coefficient (ICC), median odds ratio (MOR), likelihood ratio (LR), and deviance. Variables with a p-value less than 0.2 in the bi-variable logistic regression analysis were taken into account for the next multilevel analysis. In the multilevel analysis, significant factors were presented using the Adjusted Odds Ratio (AOR) along with the 95% Confidence Interval (CI).
The prevalence of the coexistence of anemia and undernutrition among children was 26.3% (CI: 25.2%, 27.4%). According to the multilevel logistic regression result, mothers aged 25–34 years (AOR = 1.41; 95% CI: 1.01, 1.96), no education (AOR = 1.51; 95% CI: 1.19, 1.91), primary education (AOR = 1.39; CI: 1.05, 1.84), not covered by health insurance (AOR = 2.18; 95% CI: 1.05, 2.47), rural residents (AOR = 1.46; 95% CI: 1.16, 1.84), and short maternal stature (AOR = 1.83; 95% CI: 1.49, 2.27) were associated with an increased odds of the coexistence of anemia and undernutrition among children. In contrast, tall maternal stature (AOR = 0.29; 95% CI: 0.22, 0.36) and children aged 37–47 months (AOR = 0.70; 95% CI: 0.50, 0.96) were associated with decreasing the odds of the coexistence of anemia and undernutrition among children.
In Mali, the coexistence of anemia and undernutrition contributes to mortality and related complications among children. The finding from this study revealed that children whose mothers were aged 25–34, mothers without formal education, mothers without primary education, mothers whose health was not covered by health insurance, children who lived in rural areas, and maternal short stature were associated with increased odds of the coexistence of anemia and undernutrition among children. In contrast, tall maternal stature and children aged 37–47 were associated with decreasing the odds of the coexistence of anemia and undernutrition among children.
Introduction
Anemia is a condition in which red blood cell or hemoglobin levels fall below an average [1]. Undernutrition refers to a mild, moderate, or severe nutritional deficiency needed for body growth and development. It encompasses stunting, wasting, and underweight [2,3]. According to the WHO, anemia and undernutrition were indicators for assessing hemoglobin deficiency, and micro/macro-nutritional status in children, respectively [4–6]. Both anemia and undernutrition were caused by insufficient iron as well as nutritional deficiencies and recurrent infections [7–9]. Collectively, anemia and undernutrition result in negative health consequences like poor ability to carry oxygen in the blood [10], poor emotional well-being [11], delays in body growth [12–15], impaired immune systems [16–18], poor cognitive and mental development in children [17,19,20], an increased chance of chronic disease [21], and a higher susceptibility to infections and pathogens [22]. Generally, the combined effects of both anemia and undernutrition affect development, poor growth, and challenges in motor skills [23], and impair physical and social well-being [24,25].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider financing & policy desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Halid Worku Jemil, Sonia Worku Semayneh, Eyob Tilahun Abeje, Altaseb Beyene Kassaw, Gosa Mankelkl, Anmut Endalkachew Bezie, Adisu Meles Kabtyimer. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by HealthSignal. The researchers are the authors of the source study, not members of HealthSignal’s staff.
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