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Anthropometry and Malaria among Children in Niger: A Cross-Sectional Study

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  • 1 Francis I. Proctor Foundation, University of California San Francisco, San Francisco, California;
  • 2 Programme FSS/Université Abdou Moumouni de Niamey, Programme National de Santé Oculaire, Niamey, Niger;
  • 3 Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland;
  • 4 Department of Infectious and Tropical Diseases, Clinical Research Unit, London School of Hygiene & Tropical Medicine, London, United Kingdom;
  • 5 Department of Ophthalmology, University of California San Francisco, San Francisco, California;
  • 6 Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California

The complex relationship between malnutrition and malaria affects morbidity and mortality in children younger than 5 years, particularly in parts of sub-Saharan Africa where these conditions occur together seasonally. Previous research on this relationship has been inconclusive. Here, we examine the association between anthropometric indicators and malaria infection in a population-based sample of children younger than 5 years in Niger. This cross-sectional study is a secondary analysis of a cluster-randomized trial comparing treatment strategies for trachoma in Niger. We included children aged 6–60 months residing in the 48 communities enrolled in the trial who completed anthropometric and malaria infection assessments at the final study visit. We evaluated the association between anthropometric indicators, including height-for-age z-score (HAZ) and weight-for-age z-score (WAZ) and indicators of malaria infection, including malaria parasitemia and clinical malaria. In May 2013, we collected data from 1,649 children. Of these, 780 (47.3%) were positive for malaria parasitemia and 401 (24.3%) had clinical malaria. In models of malaria parasitemia, the adjusted odds ratio (aOR) was 1.05 (95% confidence interval [CI]: 1.00–1.10) for HAZ and 1.07 (95% CI: 0.99, 1.15) for WAZ. In models of clinical malaria, the aOR was 1.07 (95% CI: 1.02–1.11) for HAZ and 1.09 (95% CI: 1.01–1.19) for WAZ. Overall, we did not find evidence of an association between most anthropometric indicators and malaria infection. Greater height may be associated with an increased risk of clinical malaria.

Author Notes

Address correspondence to Catherine E. Oldenburg, Francis I Proctor Foundation and Department of Epidemiology and Biostatistics, University of California San Francisco, 513 Parnassus Ave., S334, San Francisco, CA 94143-0412. E-mail: catherine.oldenburg@ucsf.edu

Financial support: This work was supported by the Bill & Melinda Gates Foundation [48027], National Institutes of Health [NIH/NEI K23 EYO19881-01, NIH/NCRR/OD UCSF-CTSI KL2 RR024130], Research to Prevent Blindness, That Man May See, and the Harper-Inglis Trust.

Authors’ addresses: Kieran S. O’Brien, Sun Y. Cotter, and Nicole E. Stoller, Francis I. Proctor Foundation, University of California San Francisco, San Francisco, CA, E-mails: kieran.obrien@ucsf.edu, sun.cotter@ucsf.edu, and nicolestoller@gmail.com. Abdou Amza, Boubacar Kadri, and Beido Nassirou, Programme FSS/Université Abdou Moumouni de Niamey, Programme National de Santé Oculaire, Niamey, Niger, E-mails: dr.amzaabdou@gmail.com, boubacarkadri@gmail.com, and nasbeido@yahoo.fr. Sheila K. West, Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, E-mail: shwest@jhmi.edu. Robin L. Bailey, Department of Infectious and Tropical Diseases, Clinical Research Unit, London School of Hygiene & Tropical Medicine, London, United Kingdom, E-mail: robin.bailey@lshtm.ac.uk. Travis C. Porco and Thomas M. Lietman, Francis I. Proctor Foundation, University of California San Francisco, San Francisco, CA, Department of Ophthalmology, University of California San Francisco, San Francisco, CA, and Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, E-mails: travis.porco@ucsf.edu and tom.lietman@ucsf.edu. Bruce D. Gaynor, Francis I. Proctor Foundation, University of California San Francisco, San Francisco, CA, and Department of Ophthalmology, University of California San Francisco, San Francisco, CA, E-mail: bruce.gaynor@ucsf.edu. Catherine E. Oldenburg, Francis I. Proctor Foundation, University of California San Francisco, San Francisco, CA, and Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, E-mail: catherine.oldenburg@ucsf.edu.

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