1921
Volume 80, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

In sub-Saharan Africa, malaria and malnutrition are major causes of morbidity and mortality in children less than five years of age. To explore the impact of malnutrition on subsequent susceptibility to malaria, a cohort of 874 rural preschool children in Senegal was followed-up during one malaria transmission season from July through December. Data on nutritional status and parasitemia were collected at baseline. Malaria morbidity was monitored through weekly home visits. Wasted children (weight-for-height z-score < −2) were at lower risk of having at least one subsequent clinical malaria attack (odds ratio = 0.33; 95% confidence interval = 0.13–0.81, = 0.02), whereas stunting (height-for-age z-score < −2) or being underweight (weight-for-age z-score < −2) was not associated with clinical malaria. Although non-biological explanations such as overprotection of wasted children by their mothers should be considered, immunomodulation according to nutritional status could explain the lower risk of malaria attack among wasted children.

Loading

Article metrics loading...

/content/journals/10.4269/ajtmh.2009.80.202
2009-02-01
2017-09-23
Loading full text...

Full text loading...

/deliver/fulltext/14761645/80/2/0800202.html?itemId=/content/journals/10.4269/ajtmh.2009.80.202&mimeType=html&fmt=ahah

References

  1. UNICEF, 2007. Progress for Children: A World Fit for Children: Statistical Review. New York: United Nations, 19–24.
  2. Pelletier DL, 1994. The potentiating effects of malnutrition on child mortality: epidemiologic evidence and policy implications. Nutr Rev 52 : 409–415.
  3. Fawzi WW, Herrera MG, Spiegelman DL, el Amin A, Nestel P, Mohamed KA, 1997. A prospective study of malnutrition in relation to child mortality in the Sudan. Am J Clin Nutr 65 : 1062–1069.
  4. Man WD, Weber M, Palmer A, Schneider G, Wadda R, Jaffar S, Mulholland EK, Greenwood BM, 1998. Nutritional status of children admitted to hospital with different diseases and its relationship to outcome in The Gambia, West Africa. Trop Med Int Health 3 : 678–686.
  5. Breman JG, 2001. The ears of the hippopotamus: manifestations, determinants, and estimates of the malaria burden. Am J Trop Med Hyg 64 : 1–11.
  6. Fernando D, Wickremasinghe R, Mendis KN, Wickremasinghe AR, 2003. Cognitive performance at school entry of children living in malaria-endemic areas of Sri Lanka. Trans R Soc Trop Med Hyg 97 : 161–165.
  7. Branca F, Ferrari M, 2002. Impact of micronutrient deficiencies on growth: the stunting syndrome. Ann Nutr Metab 46 (Suppl 1): 8–17.
  8. Martorell R, Rivera J, Kaplowitz H, Pollitt E, 1992. Long-term consequences of growth retardation during early childhood. Hernandez M, Argente J, eds. Human Growth: Basic and Clinical Aspects. Amsterdam: Elsevier Science Publishers B.V., 143–149.
  9. ter Kuile FO, Terlouw DJ, Phillips-Howard PA, Hawley WA, Friedman JF, Kolczak MS, Kariuki SK, Shi YP, Kwena AM, Vulule JM, Nahlen BL, 2003. Impact of permethrin-treated bed nets on malaria and all-cause morbidity in young children in an area of intense perennial malaria transmission in western Kenya: cross-sectional survey. Am J Trop Med Hyg 68 : 100–107.
  10. Bradley-Moore AM, Greenwood BM, Bradley AK, Kirkwood BR, Gilles HM, 1985. Malaria chemoprophylaxis with chloroquine in young Nigerian children. III. Its effect on nutrition. Ann Trop Med Parasitol 79 : 575–584.
  11. Snow RW, Molyneux CS, Njeru EK, Omumbo J, Nevill CG, Muniu E, Marsh K, 1997. The effects of malaria control on nutritional status in infancy. Acta Trop 65 : 1–10.
  12. Deen JL, Walraven GE, von Seidlein L, 2002. Increased risk for malaria in chronically malnourished children under 5 years of age in rural Gambia. J Trop Pediatr 48 : 78–83.
  13. Snow RW, Byass P, Shenton FC, Greenwood BM, 1991. The relationship between anthropometric measurements and measurements of iron status and susceptibility to malaria in Gambian children. Trans R Soc Trop Med Hyg 85 : 584–589.
  14. Genton B, Al-Yaman F, Ginny M, Taraika J, Alpers MP, 1998. Relation of anthropometry to malaria morbidity and immunity in Papua New Guinean children. Am J Clin Nutr 68 : 734–741.
  15. Hendrickse RG, Hasan AH, Olumide LO, Akinkunmi A, 1971. Malaria in early childhood. An investigation of five hundred seriously ill children in whom a “clinical” diagnosis of malaria was made on admission to the children’s emergency room at University College Hospital, Ibadan. Ann Trop Med Parasitol 65 : 1–20.
  16. Ahmad SH, Moonis R, Shahab T, Khan HM, Jilani T, 1985. Effect of nutritional status on total parasite count in malaria. Indian J Pediatr 52 : 285–287.
  17. Murray MJ, Murray AB, Murray NJ, Murray MB, 1978. Diet and cerebral malaria: the effect of famine and refeeding. Am J Clin Nutr 31 : 57–61.
  18. Muller O, Garenne M, Kouyate B, Becher H, 2003. The association between protein-energy malnutrition, malaria morbidity and all-cause mortality in West African children. Trop Med Int Health 8 : 507–511.
  19. Tshikuka JG, Gray-Donald K, Scott M, Olela KN, 1997. Relationship of childhood protein-energy malnutrition and parasite infections in an urban African setting. Trop Med Int Health 2 : 374–382.
  20. Cisse B, Sokhna C, Boulanger D, Milet J, Ba el H, Richardson K, Hallett R, Sutherland C, Simondon K, Simondon F, Alexander N, Gaye O, Targett G, Lines J, Greenwood B, Trape JF, 2006. Seasonal intermittent preventive treatment with artesunate and sulfadoxine-pyrimethamine for prevention of malaria in Senegalese children: a randomised, placebo-controlled, double-blind trial. Lancet 367 : 659–667.
  21. Robert V, Dieng H, Lochouran L, Traore SF, Trape JF, Simondon F, Fontenille D, 1998. Malaria transmission in the rural zone of Niakhar, Senegal. Trop Med Int Health 3 : 667–677.
  22. Delaunay V, Etard JF, Preziosi MP, Marra A, Simondon F, 2001. Decline of infant and child mortality rates in rural Senegal over a 37-year period (1963–1999). Int J Epidemiol 30: 1286–1293; discussion 1294–1295.
  23. Etard JF, Le Hesran JY, Diallo A, Diallo JP, Ndiaye JL, Delaunay V, 2004. Childhood mortality and probable causes of death using verbal autopsy in Niakhar, Senegal, 1989–2000. Int J Epidemiol 33 : 1286–1292.
  24. Simondon KB, Costes R, Delaunay V, Diallo A, Simondon F, 2001. Children’s height, health and appetite influence mothers’ weaning decisions in rural Senegal. Int J Epidemiol 30 : 476–481.
  25. Lohman TG, Roche AF, Martorell R, 1988. Anthropometric Standardization Reference Manual. Champaign, IL: Human Kinetics Books.
  26. Simondon KB, Bénéfice E, Simondon F, Delaunay V, Chahnazarian A, 1993. Seasonal variations in nutritional status of adults and children in rural Senegal. Ulijaszek SJ, Strickland SS, eds. Seasonality and Human Ecology. Cambridge, United Kingdom: Cambridge University Press, 166–183.
  27. Simondon KB, Simondon F, Costes R, Delaunay V, Diallo A, 2001. Breast-feeding is associated with improved growth in length, but not weight, in rural Senegalese toddlers. Am J Clin Nutr 73 : 959–967.
  28. Rogier C, Tall A, Diagne N, Fontenille D, Spiegel A, Trape JF, 1999. Plasmodium falciparum clinical malaria: lessons from longitudinal studies in Senegal. Parassitologia 41 : 255–259.
  29. Rogier C, 2003. Childhood malaria in endemic areas: epidemiology, acquired immunity and control strategies. Med Trop (MARS) 63 : 449–464.
  30. Friedman JF, Kwena AM, Mirel LB, Kariuki SK, Terlouw DJ, Phillips-Howard PA, Hawley WA, Nahlen BL, Shi YP, ter Kuile FO, 2005. Malaria and nutritional status among pre-school children: results from cross-sectional surveys in western Kenya. Am J Trop Med Hyg 73 : 698–704.
  31. Simondon KB, Simondon F, 1998. Mothers prolong breastfeeding of undernourished children in rural Senegal. Int J Epidemiol 27 : 490–494.
  32. Scrimshaw NS, Taylor CE, Gordon JE, 1968. Interactions of nutrition and infection. Monogr Ser World Health Organ 57 : 3–329.
  33. Schaible UE, Kaufmann SH, 2007. Malnutrition and infection: complex mechanisms and global impacts. PLoS Med 4 : e115.
  34. Cunningham-Rundles S, McNeeley DF, Moon A, 2005. Mechanisms of nutrient modulation of the immune response. J Allergy Clin Immunol 115: 1119–1128; quiz 1129.
  35. Field CJ, Johnson IR, Schley PD, 2002. Nutrients and their role in host resistance to infection. J Leukoc Biol 71 : 16–32.
  36. Shankar AH, 2000. Nutritional modulation of malaria morbidity and mortality. J Infect Dis 182 (Suppl 1): S37–S53.
  37. Prentice AM, Ghattas H, Doherty C, Cox SE, 2007. Iron metabolism and malaria. Food Nutr Bull 28 : S524–S539.
  38. Oppenheimer SJ, Gibson FD, Macfarlane SB, Moody JB, Harrison C, Spencer A, Bunari O, 1986. Iron supplementation increases prevalence and effects of malaria: report on clinical studies in Papua New Guinea. Trans R Soc Trop Med Hyg 80 : 603–612.
  39. Sazawal S, Black RE, Ramsan M, Chwaya HM, Stoltzfus RJ, Dutta A, Dhingra U, Kabole I, Deb S, Othman MK, Kabole FM, 2006. Effects of routine prophylactic supplementation with iron and folic acid on admission to hospital and mortality in preschool children in a high malaria transmission setting: community-based, randomised, placebo-controlled trial. Lancet 367 : 133–143.
  40. Nyakeriga AM, Troye-Blomberg M, Dorfman JR, Alexander ND, Back R, Kortok M, Chemtai AK, Marsh K, Williams TN, 2004. Iron deficiency and malaria among children living on the coast of Kenya. J Infect Dis 190 : 439–447.
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.2009.80.202
Loading
/content/journals/10.4269/ajtmh.2009.80.202
Loading

Data & Media loading...

  • Received : 11 Jul 2008
  • Accepted : 08 Oct 2008

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error