Deepak Singh

• Malaria remains a major global health concern, particularly affecting vulnerable populations such as children in sub-Saharan Africa regions. This thesis presents a comprehensive statistical analysis of risk factors associated with mortality, malaria, and severe malarial anemia (SMA) in children residing in Western Kenya, an area with high malaria transmission rates. The study leverages a real dataset collected from two cohorts of children, encompassing demographic, clinical, and laboratory variables. After thorough data analysis, data consists of 1654 children with repeated clinical visits. These children had multiple malaria episodes ranging between 0 to 26, 0 to 4 SMA episodes, and a total of 14 deaths. The primary objectives are to identify and quantify risk factors contributing to the incidence of mortality, malaria, and SMA. The analytical approach involves the application of various statistical methods, including logistic regression, survival analysis, Cox models, and frailty models. We explore the influence of factors such as age, gender, hemoglobin genotypes, and SMA development. Key findings from the analysis highlight the significant role of variables like hemoglobin levels with specific genetic and other factors such as HIV and Alphthalsimeia. Furthermore, the study investigates the temporal aspect of malaria episodes, considering recurrent events and frailty models to account for unobserved heterogeneity among study participants. This research provides valuable insights into the epidemiology of malaria and SMA in the context of Western Kenya. These findings contribute to the development of targeted interventions and public health strategies aimed at reducing the burden of malaria-related morbidity and mortality in children. Additionally, the study underscores the importance of continued surveillance and monitoring to adapt interventions in response to evolving risk factors and challenges. In conclusion, this thesis contributes to the broader understanding of malaria risk factors and severe malarial anemia in a specific geographical context while emphasizing the need for multifaceted approaches to combat malaria in endemic regions. It serves as a foundation for evidence-based policies and interventions, with the ultimate goal of improving the health and well-being of children in Western Kenya and similar malaria-endemic areas worldwide.