# Prevalence of anxiety and associated factors among guardians of children admitted with severe malaria at Thyolo District Hospital in Malawi

## TL;DR

This study finds that most guardians of children with severe malaria in Malawi experience mild anxiety, with factors like age, education, and hospital stay length linked to higher anxiety levels.

## Contribution

The study is one of the few to investigate anxiety prevalence and its correlates among guardians of children with severe malaria in Malawi.

## Key findings

- Mild anxiety was most common (79.7%) among guardians of children with severe malaria.
- Socio-demographic factors like age, education, and income were significantly associated with anxiety severity.
- Longer hospital stays and repeated admissions were linked to increased anxiety.

## Abstract

Anxiety is a common psychological response among caregivers of children with severe illnesses, yet limited research has explored its prevalence and associated factors in guardians of children with severe malaria in Malawi. Understanding the severity of anxiety and its correlates is crucial for supporting caregiver mental health and improving paediatric outcomes.

This study aimed to determine the prevalence and severity of anxiety, and identify social, demographic and clinical factors associated with anxiety among guardians of children admitted with severe malaria.

The study setting was the Peadiatric ward of Thyolo District Hospital in Malawi.

A cross-sectional study was conducted involving 187 guardians of children diagnosed with severe malaria. Data were collected using a structured questionnaire incorporating socio-demographic and clinical information, alongside the Generalised Anxiety Disorder 7-item (GAD-7) scale. Descriptive statistics, Chi-square tests and logistic regression were used to analyse the data.

Mild anxiety was the most common (79.7%) among participants, followed by moderate (10.7%) and minimal (9.6%), with no cases of severe anxiety. Significant socio-demographic factors associated with higher anxiety included age (p < 0.001), guardian type (p < 0.001), education level (p < 0.001), area of residence (p < 0.001) and source of income (p < 0.001). Clinically, longer hospital stays (p < 0.001) and repeated admissions (p < 0.001) were significantly associated with increased anxiety severity.

Anxiety is prevalent among guardians of children with severe malaria, with several socio-demographic and clinical factors contributing to its severity. The findings highlight the importance of integrating psychological support services into paediatric care settings.

This study underscores the need for routine anxiety screening, mental health support and context-specific interventions targeting caregivers of hospitalised children with severe illnesses in low-resource settings.