Nutritional status and malaria infection in primary school-aged children
Abstract
Background The most common nutritional problem affecting the pediatric population in developing countries is protein energy malnutrition (PEM). The nutritional problem may be caused by a variety of factors, most of which are related inadequate food intake and infection. One of the highest causes of morbidity and mortality in endemic areas is malaria. Malaria infection and nutritional status have been suggested to be interrelated.
Objective To assess for a relationship between nutritional status and malaria infection in children.
Methods This cross-sectional study was conducted in October and November 2010 in primary school children at Panyabungan City, North Sumatera Province. Peripheral thick and thin blood smear examinations were done to confirm the diagnosis of malaria. Participants were divided in two groups (malaria-infected and uninfected) by consecutive sampling. Nutritional status was determined by body weight and height measurements based on the 2000 Centers for Disease Control and Prevention (CDC) chart. The mild and moderate malnutrition classification was further sub-divided into stunted and wasted, based on the 2007 NCHS/WHO chart. Chi-square test was used to analyze the relationship between nutritional status and malaria infection.
Results There were 126 children in each group. Significant differences in mild-moderate malnutrition were found between the malaria-infected and uninfected groups (23.8% vs. 46.8%, respectively; P= 0.011). There were also significant differences between the malaria-infected and uninfected groups with regards to chronic malnutrition type: stunted (20.0% vs. 37.3%, respectively; P=0.042) and stunted-wasted (6.7% vs. 28.8%, respectively; P= 0.008) in both groups of the children with mild-moderate malnutrition.
Conclusion There are significantly more children with mild-moderate malnutrition in the uninfected group than in the malaria-infected group, furthermore, of those with mild-moderate malnutrition, there are significantly more stunted and stunted-wasted children who were uninfected than malaria-infected.
References
Takakura M, Uza M, Sasaki Y, Nagahama N, Phommpida S, Bounyadeth S, et al. The relationship between anthropometric indicators of nutritional status and malaria infection among youths in Khammouane province, Lao PDR. Southest Asian J Trop Med Public Health. 2001;32:262-7
Caulfield LE, Richard SA, Black RE. Undernutrition as an underlying cause of malaria morbidity and mortality in children less then five years old. Am J Trop Med Hyg. 2004;71:55-63.
World Health Organization. Malaria. [cited 2010 May]. Available from: http://www.who.int/mediacentre/factssheet/fs094/en.
Fernandez MC. Malaria. [cited 2010 May]. Available from: http://emedicine.medscape.com/article/784065.
Rampengan T. Malaria. In: Soedarmo SSP, Garna H, Hadinegoro SRS, Satari HI, editors. Buku ajar infeksi & pediatri tropis. 2nd ed. Jakarta: Ikatan Dokter Anak Indonesia; 2008. p. 408-37.
Pusat data dan informasi Direktorat Pengendalian Penyakit Bersumber Binatang. Epidemiologi Malaria di Indonesia. In: Pusat data dan informasi Kementerian Kesehatan RI. Buletin jendela data & informasi kesehatan, Volume 1, Triwulan I. Jakarta: Bakti Husada; 2011. p. 1-16.
Shankar AH. Nutritional modulation of malaria morbidity and mortality. J Infect Dis. 2000;182:37-53.
Probandari AN. Hubungan antara malnutrisi, suplementasi gizi dan malaria pada anak 0-5 tahun. Buletin Kesehatan Masyarakat. 2005;21:7-11.
Nasution I. Perbedaan status gizi pada penderita malaria dan tidak penderita malaria di Kabupaten Mandailing Natal [thesis]. [Medan]: Universitas Sumatera Utara; 2006.
Sowunmi A, Gbotosho GO, Adedeji AA, Fateye BA, Sabitu MF, Happi CT, et al. Effects of acute Plasmodium falciparum malaria on body weight in children in an endemic area. Parasitol Res. 2007;101:343-9.
Schrimsaw NS, SanGiovanni JP. Synergism of nutrition, infection, and immunity: an overview. Am J Clin Nutr. 1997;66:464-77.
Muller O, Garenne M, Kouyate B, Becher H. The association between protein-energy malnutrition, malaria morbidity and all-cause mortality in West African children. Trop Med Int Health. 2003;8:507-11.
Fillol F, Sarr JB, Boulanger D, Cisse B, Sokhna C, Riveau G, et al. Impact of child malnutrition on the specific anti-Plasmodium falciparum antibody response. Malar J. 2009;8:116.
Genton B, Al-Yaman F, Ginny M, Taraika J, Alpers MP. Relation of anthropometry to malaria morbidity and immunity in Papua New Guinean children. Am J Clin Nutr. 1998;68:734-41.
Mamiro PS, Kolsteren P, Roberfroid D, Tatala S, Opsomer AS, Van Camp JH. Feeding practices and factors contributing to wasting, stunting, and iron-deficiency anaemia among 3-23-month old children in Kilosa district, Rural Tanzania. J Health Popul Nutr. 2005;23:222-30.
Hauvast JL, Tolboom JJ, Kafwembe EM, Musonda RM, Mwanakasale V, Staveren WA, et al. Severe linear growth retardation in rural Zambian children: the influence of biological variables. Am J Clin Nutr. 2000;71:550-9.
Nyakeriga AM, Troye-Blomberg M, Chemtai AK, Marsh K, Williams TN. Malaria and nutritional status in children living on the coast of Kenya. Am J Clin Nutr. 2004;80:1604-10.
Williams TN, Maitland K, Phelps L, Bennet S, Peto TEA, Viji J, et al. Plasmodium vivax: a cause of malnutrition in young children. QJM. 1997;90:751-7.
Garba CMG, Mbofung CMF. Relationship between malnutrition and parasitic infection among school children in the Adamawa region of Cameroon. Pak J Nutr. 2010;9:1094-9.
Pongou R, Ezzati M, Salomon JA. Household and community socioeconomic and environmental determinants of child nutritional status in Cameroon. BMC Public Health. 2006;6:98.
Brooker S, Clarke S, Njagi JK, Polack S, Mugo B, Estambale B, et al. Spatial clustering of malaria and associated risk factors during an epidemic in a highland area of western Kenya. Trop Med Int Health. 2004;9:757-66.
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Accepted 2015-11-26
Published 2015-07-31
