Nutritional status of children in a malaria meso endemic area: cross sectional study on prevalence, intensity, predictors, influence on malaria parasitaemia and anaemia severity (original) (raw)
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African Journal of Food, Agriculture, Nutrition and Development, 2008
Malaria and malnutrition are a major health burden in developing countries with infants and children being the most vulnerable groups. The extent of the burden of malaria and malnutrition was investigated in 339 children ≤14years residing in the village of Muea located in the South West Province of Cameroon. Malaria parasitaemia was determined microscopically from Giemsa stained thick blood films. Nutritional status was determined using age and the anthropometric parameters of weight and height. Height-forage (HAZ), weight-forage (WAZ) and weight-forheight (WHZ) Z scores were computed based on the National Centre for Health Statistics (NCHS)/World Health Organisation growth reference curves. Anaemia was assessed by measuring haemoglobin (Hb) concentration while plasma iron levels were determined by spectrophotometric assays. The prevalence of malaria in the study population was 96.2% (326/339) with a majority (68.4%) having asymptomatic disease. The geometric mean parasite density (GMPD) was 744.37 ± 89396.11 (parasitaemia range 40-153190 parasites/µL blood). The mean Hb concentration was 9.29 ± 1.8g/dL (range 4-14.1g/dL) and anaemia (Hb<11g/dL) was diagnosed in 81.4% of the children, a majority of whom had microcytic anaemia. A negative correlation was observed between parasite density and haemoglobin concentration (r =-0.14). The mean plasma iron level was 53.64 ± 32.87µL/dl (range 1.8-159) with 58.7% (199/339) of the children diagnosed as iron deficient (plasma iron concentrations <50µg/dL). A negative correlation was observed between plasma iron values and malaria parasitaemia (r =-0.031). The prevalence of malnutrition was 58.1% (197/339). Of the 197 malnourished children, 23.6% were wasted (<-2 SD weight-for-height Z-score), 26.5% underweight (<-2 SD weight-forage Z score) and 49.9% stunted (<-2 SD height-forage Z score). There was a negative correlation between nutritional status and malaria parasitaemia (r =-0.034). The findings from this study are strongly suggestive that falciparum malaria and malnutrition exist in children residing in Muea and constitute a major health problem which needs to be immediately addressed to reduce morbidity and mortality.
Malaria Journal
Background: Malaria, anaemia and malnutrition are frequently co-existing diseases that cause significant morbidity and mortality particularly among children. This study measured the prevalence, intensity and evaluated risk factors for malaria parasitaemia, anaemia and malnutrition among children living at low versus high altitude settings in the Mount Cameroon area. Methods: A cross-sectional community based survey involving 828 children aged 6 months to 14 years was conducted between July and November 2017. Malaria parasitaemia was confirmed by light microscopy, haemoglobin concentration was measured using an auto haematology analyser, nutritional status was determined from the anthropometric measurements collected, and socioeconomic status related variables by the use of questionnaire. Anaemia and malnutrition were defined according to World Health Organization standards. Associations between predictor variables and primary outcomes were assessed using logistic regression analysis. Results: Malaria parasite and anaemia were prevalent in 41.7% and 56.2% of the children, respectively while, malnutrition prevalence was 34.8% with wasting, underweight and stunting occurring in 25.7%, 19.9% and 23.7% of them respectively. Overall malaria parasite geometric mean density was 413/µL of blood (range 100-27,060). The odds of having malaria parasitaemia was highest in children 5-9 years of age [odd ratio (OR) = 1.69, P = 0.006], living in lowland (OR = 1.48, P = 0.008) as well as those whose domestic water was collected from an open source (streams/ springs) (OR = 1.81, P = 0.005) than their counterparts. Being < 5 years (OR = 3.15, P = < 0.001) or 5-9 years (OR = 2.20, P < 0.001) of age, having malaria parasite (OR = 2.07, P = < 0.001) and fever in the past 2 days (OR = 1.52, P < 0.04) were identified as significant risk factors of anaemia while the age group < 5 years was the only significant risk (OR = 3.09, P = < 0.001) associated with malnutrition. Conclusion: While age specific attention should be given in the control of malaria (5-9 years), anaemia (< 10 years) and malnutrition (< 5 years), the existing malaria control programmes should be revised to integrate anaemia and malnutrition control strategies so as to improve upon the health of the children.
Childhood asymptomatic malaria and nutritional status among Port Harcourt children
East African journal of public health, 2007
Objective: Our study in Port Harcourt children with asymptomatic malaria aimed at assessing the baseline anthropometric indices of nutritional status, and whether their nutritional status (especially under nutrition) offers any advantage for living in malaria endemic areas. Design: Cross-sectional study was used. Setting: Rumueme Community in Port Harcourt, Nigeria. Subjects: Apparently healthy children aged 1-8 years of both sexes (Boys = 117, Girls = 123; Ratio 1: 1.05), 240 children from randomly selected households within the study community participated in the study. Results: Of the 240 children, 66 (27.5%) were infected with malaria (P falciparum). Children below 5 years had a higher parasitaemic rate (36.36%) than those in 5-8 years group (21.27%). Our baseline data showed that 17.5% were underweight (WFA Z <-2), 3.75% were stunted (HFA Z <-2) and 22.5% were wasting (WFH Z <-2). Children who are underweight were found to be at higher risk of acquiring malaria infection than the well nourished children (RR = 1.02, χ 2 = 0.320, p < 0.02, 95% CI 0.34-2.37). Under nutrition was more prominent in the children below 5 years than the older children (RR = 3.625, χ 2 = 10.36, p < 0.006, 95% CI I.81-5.43). The haemoglobin value of parasitized children (10.8 ± 1.9 g/dl) was significantly lower than the non-parasitized group (11.3 ± 1.7 g/dl,) (p < 0.01). Conclusion: We concluded that the presence of under nutrition places children (especially below 5 years of age) at higher risk of malaria related morbidity. Children in malaria endemic areas need adequate nutrition to withstand the negative impact of malaria.
Tropical Medicine and Health, 2022
Background: Anaemia, anisocytosis, malnutrition (especially stunting) are common health problems in developing countries with children being the most vulnerable. These conditions have negative impacts on human performance, growth and development, and can further be complicated if comorbidity exists within a holoendemic stratum with strong and perennial malaria parasite transmission such as the Mount Cameroon area. The study aimed at determining the prevalence and severity malnutrition, anaemia and anisocytosis in children ≤ 5 years, living in the conflict hit malaria perennial transmission zone of the Mount Cameroon area. Method: A cross-sectional community-based survey involving 628 children ≤ 5 years was conducted. Malaria parasitaemia was confirmed by Giemsa-stained microscopy and the density was log transformed. Haemoglobin (Hb), mean cell volume and red blood cell distribution width were estimated using an auto-haematology analyser and defined according to WHO standards. Anthropometric indices were analysed and compared with WHO growth reference standards using WHO Anthro software. Results: Plasmodium infection, anaemia, microcytic anaemia, anisocytosis and stunting were prevalent in 36.0, 72.8, 30.1, 54.1 and 29.0% of the children, respectively. The ≤ 24 months children were more moderately stunted (14.7%), with higher prevalence of microcytic anaemia (38.8%) and anisocytosis (68.8%) (P < 0.002 and P < 0.001, respectively) when compared with the older children. The mean Hb level in the study population was 10.04 g/dL with children ≤ 24 months having the least mean haemoglobin level (9.69 g/dL) when compared with their older counterparts at P < 0.001. The odds of having anisocytosis were highest among children who were malnourished (OR = 4.66, P = 0.005), those infected with malaria parasites (OR = 1.85, P = 0.007), and whose parents had a primary (OR = 3.51, P = 0.002) and secondary levels of education (OR = 2.69, P = 0.017).
Infectious Diseases of Poverty, 2017
Background: Recent studies have presented conflicting findings about whether malaria is associated with an increased or decreased risk of malnutrition. Therefore, assessing the relationship between these two disastrous diseases in the most vulnerable groups, such as in children aged below 5 years (under-five children), may lead to the discovery of new low-cost and effective aides to current methods of malnutrition prevention in malariaendemic areas. Therefore, this study was conducted to assess the relationship between malaria and malnutrition among under five children in an area with a high degree of malaria transmission. Methods: The study involved comparing malnourished children aged 6-59 months and nourished children of the same age for their past exposure to malaria, in Shashogo District, Southern Ethiopia. A validated structured questionnaire was used to collect home to home socioeconomic data and anthropometric instruments for clinical data. The collected data were analysed using descriptive and inferential statistics by means of EpiData entry software and STATA data analysis software. Results: A total of 356 (89 malnourished and 267 nourished) under-five children participated in the study. Previous exposure to Plasmodium infection was found to be a predictor for the manifestation of malnutrition in under-five children (P = 0.02 [OR = 1.87, CI = 1.115-3.138]). Children from a household with a monthly income of less than USD 15 were 4.5 more likely to be malnourished as compared to the other children (P = 0.001 [OR = 0.422, CI = 0.181-0.978]). Conclusion: This study found that exposure to Plasmodium has a significant impact on the nutritional status of children. In addition, socio-demographic factors, such as family income, may play a role in determining whether children are malnourished or not and may lead to increased morbidity due to malnourishment in children living in malaria-endemic areas. Therefore, malnutrition control interventions should be consolidated with malaria prevention strategies particularly in high malaria transmission areas.
Malaria and Nutritional Status of Children in Anambra State, Nigeria
Asian Journal of Research in Zoology, 2020
Malaria is a major cause of morbidity especially in children less than five years of age. This study was conducted to determine the relationship between malaria infection and nutritional status of some purposely selected children aged 0-36 months from hospitals in Anambra State, Nigeria. Data were collected on nutritional status using anthropometric data-age, height, weight and mid-upper arm circumference (MUAC). Malaria infection status was obtained through microscopic examination of thick films blood smears. The prevalence of malnutrition (weight-for-height Z-scores) among malaria uninfected in the community and hospital surveys was 26.7% and 9.2% respectively, while the prevalence among the malaria parasite infected children was 21.4% and 7.4% in the community and hospital respectively. The average number of malnourished children Original Research Article Okeke et al.; AJRIZ, 3(4): 61-74, 2020; Article no.AJRIZ.62537 62 with Z-scores <-2SD were slightly higher than WHO standard. More malaria infected boys had Z-scores <-2SD compared to the WHO standard. Prevalence of malnutrition based on MUAC among malaria parasite infected children was very high (100% and 98.1% in community and hospital, respectively). The average number of stunted (height-forage Z-score) children in both community and hospital survey was very high compare to WHO standard. It may be concluded that there is a high rate of malnutrition based on MUAC among malaria infected children in Anambra State.
Background: Malaria and malnutrition are the major causes of morbidity and mortality in under-five children in developing countries such as Ethiopia. Malnutrition is the associated cause for about half of the deaths that occur among under-five children in developing countries. However, the relationship between malnutrition and malaria is controversial still, and it has also not been well documented in Ethiopia. The aim of this study was to assess whether malnutrition is associated with malaria among under-five children. Methods: A case-control study was conducted in Adami Tulu District of East Shewa Zone in Oromia Regional State, Ethiopia. Cases were all under-five children who are diagnosed with malaria at health posts and health centres. The diagnosis was made using either rapid diagnostic tests or microscopy. Controls were apparently healthy under-five children recruited from the community where cases resided. The selection of the controls was based on World Health Organization (WHO) cluster sampling method. A total of 428 children were included. Mothers/caretakers of under-five children were interviewed using pre-tested structured questionnaire prepared for this purpose. The nutritional status of the children was assessed using an anthropometric method and analyzed using WHO Anthro software. A multivariate logistic analysis model was used to determine predictors of malaria. Results: Four hundred twenty eight under-five children comprising 107 cases and 321 controls were included in this study. Prevalence of wasting was higher among cases (17.8 %) than the controls (9.3 %). Similarly, the prevalence of stunting was 50.5 % and 45.2 % among cases and controls, respectively. Severe wasting [Adjusted Odds Ratio (AOR) =2.9, 95 % CI (1.14, 7.61)] and caretakers who had no education [AOR = 3, 95 % CI (1.27, 7.10)] were independently associated with malarial attack among under-five children. Conclusion: Children who were severely wasted and had uneducated caretakers had higher odds of malarial attack. Therefore, special attention should be given for severely wasted children in the prevention and control of malaria.
PLOS ONE, 2019
Background Despite malaria, malnutrition and anaemia being major public-health challenges in Cameroon, very little has been reported on the interaction between these interconnected health determinants. This study therefore sought to investigate the relationship between malaria, anaemia, nutritional and socioeconomic status amongst under-ten children living in six localities within two health districts in the North Region of Cameroon. Methods Accordingly, a cross-sectional survey was conducted during the peak malaria season in November 2014, in Pitoa and Mayo-Oulo Health Districts. Three hundred and sixty eight children aged 6months-10 years were enrolled. Structured questionnaires were used to assess socioeconomic status. Anthropometric indices were taken using standard methods and nutritional status assessed by calculating Height for Age (HA), Weight for Age (WA) and Weight for Height (WH) z-scores to determine stunting, underweight and wasting respectively. Finger-prick blood samples were used to prepare thin and thick blood smears for microscopy. Whole blood was collected to determine the PCV and blood spots on filter paper were used to extract plasmodium DNA for speciation by PCR.
Parasites & vectors, 2018
Malnutrition is common in children in sub-Saharan Africa and is thought to increase the risk of infectious diseases, including malaria. The relationship between malnutrition and malaria was examined in a cohort of 6-59 month-old children in rural Gambia, in an area of seasonal malaria transmission. The study used data from a clinical trial in which a cohort of children was established and followed for clinical malaria during the 2011 transmission season. A cross-sectional survey to determine the prevalence of malaria and anaemia, and measure the height and weight of these children was carried out at the beginning and end of the transmission season. Standard anthropometric indices (stunting, wasting and underweight) were calculated using z-scores. At the beginning of the transmission season, 31.7% of children were stunted, 10.8% wasted and 24.8% underweight. Stunting was more common in Fula children than other ethnicities and in children from traditionally constructed houses compared...
Malaria Journal, 2015
Background: Malaria is preventable and treatable when recommended interventions are properly implemented. Thus, diagnosis and treatment focus on symptomatic individuals while asymptomatic Plasmodium infection (PI) plays a role in the sustainability of the transmission and may also have an impact on the morbidity of the disease in terms of anaemia, nutritional status and even cognitive development of children. The objective of this study was to assess PI prevalence and its relationship with known morbidity factors in a vulnerable but asymptomatic stratum of the population. Methods: A simple random sample, household survey in asymptomatic children under the age of five was conducted from April to September 2012 in two health areas of the health zone of Mont Ngafula 1, Kinshasa, Democratic Republic of Congo. Results: The PI prevalence were 30.9% (95% CI: 26.5-35.9) and 14.3% (95% CI: 10.5-18.1) in Cité Pumbu and Kindele health areas, respectively, (OR: 2.7; p <0.001). All were Plasmodium falciparum infected and 4% were co-infected with Plasmodium malariae. In Cité Pumbu and Kindele, the prevalence of anaemia (haemoglobin <11 g/dL) was 61.6% (95% CI: 56.6-66.5) and 39.3% (95% CI: 34.0-44.6), respectively, (OR: 2.5; p <0.001). The health area of Cité Pumbu had 32% (95% CI: 27.5-37.0) of chronic malnutrition (HAZ score ≤ −2SD) compared to 5.1% (95% CI: 2.8-7.6) in Kindele. PI was predictor factor for anaemia (aOR: 3.5, p =0.01) and within infected children, there was an inverse relationship between parasite density and haemoglobin level (β = −5*10 −5 , p <0.001). Age older than 12 months (aOR: 3.8, p = 0.01), presence of anaemia (aOR: 3.4, p =0.001), chronic malnutrition (aOR: 1.8, p = 0.01), having a single parent/guardian (aOR: 1.6, p =0.04), and the non-use of insecticide-treated nets (aOR: 1.7, p = 0.04) were all predictors for PI in the overall population. Conclusion: PI in asymptomatic children was correlated with anaemia and chronic malnutrition and was thus a harmful condition in the study population. Malaria control initiatives should not only focus on treatment of symptomatic infections but also take into consideration asymptomatic but infected children.