Abstract
The impacts of acute falciparum malaria on body weight and the host and parasite factors predictive of change in body weight were characterized in 465 prospectively studied children in an endemic area of southwest Nigeria. Pre-treatment weights were significantly lower than the 14 to 28-day post-treatment weights (P = 0.0001). In 187 children, fractional fall in body weight (FFBW) exceeded 4.9%. FFBW correlated negatively with age and body weight (P = 0.014 and 0.0001, respectively), but not with enrolment parasitaemia. In a multiple regression model, an age ≤5 years (AOR = 2.03, 95% CI 1.2–3.2, P = 0.003), a hematocrit ≤29% (AOR = 1.6, 95% CI 1.0–2.3, P = 0.037), and a body weight ≤9.6 kg (AOR = 5.4, 95% CI 1.7–20, P = 0.003) were independent predictors of FFBW ≥5% at presentation. Children who, after initial clearance, had recurrence of their parasitaemia within 28 days had a significantly higher propensity not to gain weight than children who were aparasitaemic after treatment (log-rank statistic 6.76, df = 1, P = 0.009). These results indicate that acute malaria contribute to sub-optimal growth in young children and may have implications for malaria control efforts in sub-Saharan Africa.
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References
Anonymous (1994) Epi Info Version 6. A word processing data base and statistics program for public health on IBM-compatible microcomputers. Centers for Disease Control and Prevention, Atlanta, GA
Anonymous (1999) SPSS for windows release 10.01 (standard version). SPSS Inc, Chicago, IL, USA
Breman JG (ed) (2001) The intolerable burden of malaria: a new look at the numbers. Am J Trop Med Hyg 64(Suppl 1–2):1–106
Breman JG, Alilio MS, Mills A (eds) (2004) The intolerable burden of malaria: II. What’s new, what’s needed. Am J Trop Med Hyg 71(Suppl 2):1–282
Crawley J (2004) Reducing the burden of anemia in infants and young children in malaria-endemic countries of Africa: from evidence to action. Am J Trop Med Hyg 71(Suppl 2):25–34
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
Gravenor MB, Lloyd AL, Kremsner PG, Missinou MA, English M, Marsh K, Kwiatkowski D (2002) A model for estimating total parasite load in falciparum malaria patients. J Theor Biol 217:137–148
Karney WW, Tong MJ (1972) Malabsorption in Plasmodium falciparum malaria. Am J Trop Med Hyg 21:1–5
Kern P, Hemmer CJ, Van Damme J, Gruss HJ, Dietrich M (1989) Elevated tumor necrosis factor alpha and interleukin-6 serum levels as markers for complicated Plasmodium falciparum malaria. Am J Med 87:139–143
Kwiatkowski D, Cannon JG, Monague KR, Cerami A, Dinarello CA, Greenwood BM (1989) Tumor necrosis factor production in falciparum malaria and its association with schizont rupture. Clin Exp Immunol 77:361–366
Kwiatkowski D, Hill AV, Sambou I, Twumasi P, Castracane J, Monague KR, Cerami A, Brewster DR, Greenwood BM (1990) TNF concentration in fatal cerebral, non-fatal cerebral and uncomplicated Plasmodium falciparum malaria. Lancet 336:1201–1204
Man WDC, 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. Trop Med Int Health 3:678–686
McGregor IA (1982) Malaria: nutritional implications. Rev Infect Dis 4:798–804
Nyarikega AM, Troye-Blomberg M, Chemtai AK, Marsh K, Williams TN (2004) Malaria and nutritional status in children living on the coast of Kenya. Am J Clin Nutr 80:1604–1610
Onwuamaegbu ME, Henein M, Coats AJ (2004) Cachexia in malaria and heart failure: therapeutic considerations in clinical practice. Postgrad Med J 80:642–649
Price R, Simpson JA, Nosten F, Luxemburger C, Hkirjaroen L, ter Kuile F, Chongsuphajaisiddhi T, White NJ (2001) Factors contributing to anemia after uncomplicated falciparum malaria. Am J Trop Med Hyg 65:614–622
Salako LA, Ajayi FO, Sowunmi A, Walker O (1990) Malaria in Nigeria: a revisit. Ann Trop Med Parasitol 84:435–445
Shiff C, Checkley W, Winch P, Premji Z, Minjas J, Lubega P (1996) Changes in weight gain and anaemia attributable to malaria in Tanzanian children living under holoendemic conditions. Trans R Soc Trop Med Hyg 90:217–296
Sowunmi A, Fateye BA, Adedeji AA, Fehintola FA, Gbotosho GO, Happi TC, Tambo E, Oduola AMJ (2005) Predictors of the failure of treatment with chloroquine in children with acute, uncomplicated, Plasmodium falciparum malaria in an area with high and increasing chloroquine resistance. Ann Trop Med Parasitol 99:535–544
Tracey KJ, Cerami A (1992) Tumor necrosis factor in the malnutrition (cachexia) of infection and cancer. Am J Trop Med Hyg 47:2–7
Verhoef H, West CE, Veenemans J, Beguin Y, Kok FJ (2002) Stunting may determine the severity of malaria-associated anaemia in African children. Pediatr 110:e48
World Health Organization (2000) Severe falciparum malaria. Trans R Soc Trop Med Hyg 94(Suppl 1):1–90
Wilairatana P, Meddings JB, Ho M, Vannaphan S, Looareesuwan S (1997) Increased gastrointestinal permeability in patients with Plasmodium falciparum malaria. Clin Infect Dis 24:430–435
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The study received financial support from the UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases. AS was supported by a WHO/TDR Career Development Award. We thank our clinic nurse and assistant, Moji Amao and Adeola Alabi, respectively, for help with running the study.
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Sowunmi, A., Gbotosho, G.O., Adedeji, A.A. et al. Effects of acute Plasmodium falciparum malaria on body weight in children in an endemic area. Parasitol Res 101, 343–349 (2007). https://doi.org/10.1007/s00436-007-0494-y
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DOI: https://doi.org/10.1007/s00436-007-0494-y