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Undernutrition is highly prevalent in many areas in which morbidity and mortality from malaria is unacceptably high. That undernutrition exacerbates diarrhea and respiratory infections is widely demonstrated; however, research suggests that it may exacerbate, palliate, or have little effect on malaria outcomes. This review examines the global burden of malaria associated with various nutrient deficiencies as well as underweight status in children 0–4 years of age. Although the association is complex and requires additional research, improved nutritional status lessens the severity of malaria episodes and results in fewer deaths due to malaria. Deficiencies in vitamin A, zinc, iron, folate, as well as other micronutrients are responsible for a substantial proportion of malaria morbidity and mortality. It is recommended that nutrition programs be integrated into existing malaria intervention programs.
Received September 3, 2003. Accepted for publication December 6, 2003.
Authors’ addresses: Laura E. Caulfield and Stephanie A. Richard, Center for Human Nutrition, The Johns Hopkins University Bloomberg School of Public Health, 615 North Wolfe Street, Room W2041, Baltimore, MD 21205, Telephone: 410-955-2786, Fax: 410-955-0196, E-mails: lcaulfie{at}jhsph.edu and strichar{at}jhsph.edu. Robert E. Black, Department of International Health, The Johns Hopkins University Bloomberg School of Public Health, 615 North Wolfe Street, Room E8527, Baltimore, MD 21205, Telephone: 410-955-3934, Fax: 410-955-7159, E-mail: rblack{at}jhsph.edu.
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