Climatic Drivers of Malaria risk in Children Under Five: A Large-Scale Analysis of individual-level data for 350,000 children in 26 Sub-Saharan African Countries

Background Malaria risk is influenced by climatic conditions, and children under five are particularly vulnerable due to their limited acquired immunity. We investigate the association between climatic factors and malaria risk in 350,000 children aged 5-59 months in sub-Saharan Africa over 18 years. Methods We included children aged 5-59 months with malaria tests from Demographic and Health Surveys (DHS) in 26 sub-Saharan African countries between 2006 and 2023. We linked these data to high-resolution climate exposures: temperature, precipitation, soil moisture, actual evapotranspiration and specific humidity. We fitted a mixed-effect logistic regression model incorporating Distributed Lag N