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Journal article

Malaria and nutritional status among children with severe acute malnutrition in Niger: A prospective cohort study

Abstract:

Background

The relationship between malaria infection and nutritional status is complex. Previous studies suggest malaria may increase the incidence and severity of malnutrition, while malnutrition may increase the risk of malaria infection. Here, we report bidirectional associations between malaria and nutritional status among children with uncomplicated severe acute malnutrition (SAM).

Methods

This study is a secondary analysis of a randomized, controlled trial for the treatment of uncomplicated SAM in Niger. Children aged 6–59 months were enrolled and followed for 12 weeks. Malaria infection was assessed using an histidine-rich protein 2 (HRP2) rapid diagnostic test at admission and at any follow-up visit with fever. We assessed the association of nutritional status at admission on malaria incidence using Cox proportional hazards regression and malaria infection at admission on nutritional recovery and weight and height gain using linear regression.

Results

Of 2399 children included in the analysis, 1327 (55.3%) were infected with malaria at admission. Malaria incidence was 12.1 cases/100 person-months among those without malaria infection at admission. Nutritional status at admission was not associated with malaria incidence. Children with malaria infection at admission and subsequently treated with an artemisinin-based combination therapy had increased weight gain (0.38 g/kg/day; 95% confidence interval [CI], 0.07 to 0.69) and reduced height gain (−0.002 mm/day; 95% CI, −0.004 to −0.0008).

Conclusions

Malaria infection was common among children treated for uncomplicated SAM. Malaria infection may impair height gain. Proper medical and nutritional management should be ensured to prevent adverse effects of malaria infection.

Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1093/cid/ciy207

Authors

More by this author
Institution:
University of Oxford
Division:
Medical Sciences Division
Department:
NDM; Tropical Medicine
Role:
Author
ORCID:
0000-0002-6008-2963


Publisher:
Oxford University Press
Journal:
Clinical Infectious Diseases More from this journal
Volume:
67
Issue:
7
Pages:
1027–1034
Publication date:
2018-03-07
Acceptance date:
2018-03-06
DOI:
EISSN:
1537-6591
ISSN:
1058-4838
Pmid:
29522089


Language:
English
Keywords:
Pubs id:
pubs:831390
UUID:
uuid:5ffa14a0-45f4-4164-9cf3-78a30467ca18
Local pid:
pubs:831390
Source identifiers:
831390
Deposit date:
2018-04-23
ARK identifier:

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