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Surveillance of the clinical morbidity of malaria remains key for disease monitoring for subsequent development of appropriate interventions. This case study presents the current status of malaria morbidities following a second round of mass distribution of long-lasting insecticidal nets (LLINs) on Ukerewe Island, northwestern Tanzania. A retrospective review of health-facility registers to determine causes of inpatient morbidities for every admitted child aged 5 years was conducted to ascertain the contribution of malaria before a