The effect of malaria on stunting: an instrumental variables approach.

Background Previous studies have found mixed evidence for an effect of malaria on stunting, but have suffered from concerns about confounding and/or power. Currently, an effect of malaria on stunting is not included in the Lives Saved Tool (LiST) model. Methods We used instrumental variables regression with the sickle cell trait and random assignment to bednets as instruments in the analysis of data on children aged 0–2 y from a bednet trial in western Kenya. Results We estimated that one additional clinical malaria episode per year increases the odds of a child being stunted by 6% (OR estimate: 1.06, 95% CI 1.01 to 1.11). Conclusions Our finding that malaria affects stunting suggests that an effect of malaria on stunting in young children should be considered in the LiST model.