Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Malaria Journal
Published in: Malaria Journal 1/2015

Open Access 01-12-2015 | Research

Association between anthropometry-based nutritional status and malaria: a systematic review of observational studies

Authors: Efrem d’Avila Ferreira, Márcia A. Alexandre, Jorge L. Salinas, André M. de Siqueira, Silvana G. Benzecry, Marcus V. G. de Lacerda, Wuelton M. Monteiro

Published in: Malaria Journal | Issue 1/2015

Login to get access

Abstract

Background

Multiple studies in various parts of the world have analysed the association of nutritional status on malaria using anthropometric measures, but results differ due to the heterogeneity of the study population, species of the parasite, and other factors involved in the host and parasite relationship. The aim of this study was to perform a systematic review on the inter-relationship of nutritional status based on anthropometry and malarial infection.

Methods

Two independent reviewers accessed the MEDLINE and LILACS databases using the same search terms related to malaria and anthropometry. Prospective studies associating anthropometry and malaria (incidence or severity) were selected. References from the included studies and reviews were used to increase the review sensitivity. Data were extracted using a standardized form and the quality of the prospective studies was assessed. Selected articles were grouped based on exposures and outcomes.

Results

The search identified a total of 1688 studies: 1629 from MEDLINE and 59 from LILACS. A total of 23 met the inclusion criteria. Five additional studies were detected by reading the references of the 23 included studies and reviews, totaling 28 studies included. The mean sample size was 662.1 people, ranging from 57 to 5620. The mean follow-up was 365.8 days, ranging from 14 days to 1 year and 9 months, and nine studies did not report the follow-up period. Prospective studies assessing the relationship between malaria and malnutrition were mostly carried out in Africa. Of the 20 studies with malarial outcomes, fifteen had high and five had average quality, with an average score of 80.5 %. Most anthropometric parameters had no association with malaria incidence (47/52; 90.4 %) or parasite density (20/25; 80 %). However, the impact of malnutrition was noted in malaria mortality and severity (7/17; 41.2 %). Regarding the effects of malaria on malnutrition, malaria was associated with very few anthropometric parameters (8/39; 20.6 %).

Conclusions

This systematic review found that most of the evidence associating malaria and malnutrition comes from P. falciparum endemic areas, with a significant heterogeneity in studies’ design. Apparently malnutrition has not a great impact on malaria morbidity, but could have a negative impact on malaria mortality and severity. Most studies show no association between malaria and subsequent malnutrition in P. falciparum areas. In Plasmodium vivax endemic areas, malaria was associated with malnutrition in children. A discussion among experts in the field is needed to standardize future studies to increase external validity and accuracy.
Literature
1.
Scrimshaw NS, SanGiovanni JP. Synergism of nutrition, infection, and immunity: an overview. Am J Clin Nutr. 1997;66:464S–77S.PubMed
2.
Man WD, Weber M, Palmer A, Schneider G, Wadda R, Jaffar S, et al. Nutritional status of children admitted to hospital with different diseases and its relationship to outcome in The Gambia, West Africa. Trop Med Int Health. 1998;3:678–86.CrossRefPubMed
3.
Raiten DJ, Sakr Ashour FA, Ross AC, Meydani SN, Dawson HD, et al. Inflammation and nutritional science for programs/policies and interpretation of research evidence (INSPIRE). J Nutr. 2015;145:1039S–108S.CrossRefPubMed
4.
5.
UNICEF. Progress for children: a World fit for children: statistical review. New York: United Nations; 2007. p. 19–24.
6.
Rice AL, Sacco L, Hyder A, Black RE. Malnutrition as an underlying cause of childhood deaths associated with infectious diseases in developing countries. Bull World Health Organ. 2000;78:1207–21.PubMedCentralPubMed
7.
Olumese PE, Sodeinde O, Ademowo OG, Walker O. Protein energy malnutrition and cerebral malaria in Nigerian children. J Trop Pediatr. 1997;43:217–9.CrossRefPubMed
8.
Imbert P, Sartelet I, Rogier C, Ka S, Baujat G, Candito D. Severe malaria among children in a low seasonal transmission area, Dakar, Senegal: influence of age on clinical presentation. Trans R Soc Trop Med Hyg. 1997;91:22–4.CrossRefPubMed
9.
Nacher M, Singhasivanon P, Vannaphan S, Treeprasertsuk S, Phanumaphorn M, Traore B, et al. Socio-economic and environmental protective/risk factors for severe malaria in Thailand. Acta Trop. 2001;78:139–46.CrossRefPubMed
10.
Nacher M, Singhasivanon P, Treeprasertsuk S, Vannaphan S, Traore B, Looareesuwan S, et al. Intestinal helminths and malnutrition are independently associated with protection from cerebral malaria in Thailand. Ann Trop Med Parasitol. 2002;96:5–13.CrossRefPubMed
11.
Ahmad SH, Moonis R, Shahab T, Khan HM, Jilani T. Effect of nutritional status on total parasite count. Ind J Pediatr. 1985;52:285–8.CrossRef
12.
Goyal SC. Protein energy malnutrition and cerebral malaria. J Trop Pediatr. 1991;37:141–4.CrossRef
13.
Hendrickse RG, Hasan AH, Olumide LO, Akinkunmi A. An investigation of five hundred seriously ill children in whom a “clinical” diagnosis of malaria was made on admisssion to the Children’s Emergency Room at University College Hospital, Ibadan. Ann Trop Med Parasitol. 1971;65:1–20.PubMed
14.
Thuma PE, van Dijk J, Bucala R, Debebe Z, Nekhai S, Kuddo T, et al. Distinct clinical and immunologic profiles in severe malarial anemia and cerebral malaria in Zambia. J Infect Dis. 2011;203:211–9.PubMedCentralCrossRefPubMed
15.
Mitangala PN, D’Alessandro U, Donnen P, Hennart P, Porignon D, Bisimwa Balaluka G, et al. Infection palustre et état nutritionnel: résultats d’une cohorte d’enfant âges de 6 à 59 mois au Kivu en République démocratique du Congo. Rev Epidemiol Santé Publique. 2013;61:111–20.CrossRefPubMed
16.
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.PubMed
17.
Fillol F, Cournil A, Boulanger D, Cissé B, Sokhna C, Targett G, et al. Influence of wasting and stunting at the onset of the rainy season on subsequent malaria morbidity among rural preschool children in Senegal. Am J Trop Med Hyg. 2009;80:202–8.PubMed
18.
Faye O, Correa J, Camara B, Dieng T, Dieng Y, Gaye O, et al. Malaria letality in pediatric unit of Dakar hospital: study of risk factors. Méd Trop. 1998;58:361–4.
19.
Razanamparany MS, Randriamiharisoa FA, Razanamparany NJ, Ramialimanana V. L’épidémie de paludisme à Antananarivo de 1983 à 1994 vue à travers le service de Pédiatrie A de l’Hôpital général de Befelatanana. Cahiers Santé. 1995;5:382–5.PubMed
20.
Renaudin P. Evaluation de l’etat nutritionnel de l’enfant de moins de 5 ans a Moundou, Tchad: relations avec la morbidite et la mortalite hospitalieres. Med Trop (Mars). 1997;57:49–54.PubMed
21.
Van Den Broeck J, Eeckels R, Vuylsteke J. Influence of nutritional status on child mortality in rural Zaire. Lancet. 1993;341:1491–5.CrossRef
22.
Genton B, Al-Yaman F, Alpers MP, Mokela D. Indicators of fatal outcome in paediatric cerebral malaria: a study of 134 comatose papua new guinean children. Int J Epidemiol. 1997;26:670–6.CrossRefPubMed
23.
World Health Organization. Severe falciparum malaria. Trans R Soc Trop Med Hyg. 2000;94:S1–90.CrossRef
24.
Downs S, Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health. 1998;52:377–84.PubMedCentralCrossRefPubMed
25.
National Center for Health Statistics. NCHS Growth curves for children, birth-18 years. United States: Vital and Health Statistics; 1977. p. 1–74.
26.
WHO Multicentre Growth Reference Study Group. WHO Child Growth Standards: length/height-for-age, weight-for-age, weight-for-length weight-for-height and body mass index-for-age: methods and development. Geneva: World Health Organization; 2006 (Accessed 15 Aug 2015).
27.
Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ. 2007;85:660–7.PubMedCentralCrossRefPubMed
28.
Pazzaglia G, Woodward WE. An analysis of the relationship of host factors to clinical falciparum malaria by multiple regression techniques. Am J Trop Med Hyg. 1982;31:202–10.PubMed
29.
Snow RW, Byass P, Shenton FC, Greenwood BM. The relationship between anthropometric measurements and measurements of iron status and susceptibility to malaria in Gambian children. Trans R Soc Trop Med Hyg. 1991;85:584–9.CrossRefPubMed
30.
Williams TN, Maitland K, Phelps L, Bennett S, Peto TE, Viji J, et al. Plasmodium vivax: a cause of malnutrition in young children. Q J Med. 1997;90:751–7.CrossRef
31.
Schellenberg D, Menendez C, Kahigwa E, Font F, Galindo C, Acosta C, et al. African children with malaria in an area of intense Plasmodium falciparum transmission: features on admission to the hospital and risk factors for death. Am J Trop Med Hyg. 1999;61:431–8.PubMed
32.
Tonglet R, Mahangaiko Lembo E, Zihindula PM, Wodon A, Dramaix M, et al. How useful are anthropometric, clinical and dietary measurements of nutritional status as predictors of morbidity of young children in central Africa? Trop Geogr Med. 1999;4:120–30.
33.
Deen JL, Walraven GEL, von Seidlen L. Increased risk for malaria in chronically malnourished children under 5 years of age in rural Gambia. J Trop Pediatr. 2002;48:78–83.CrossRefPubMed
34.
Müller O, Garenne M, Kouyaté 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.CrossRefPubMed
35.
Mockenhaupt FP, Ehrhardt S, Burkhardt J, Bosomtwe SY, Laryea S, Anemana SD, et al. Manifestation and outcome of severe malaria in children in northern Ghana. Am J Trop Med Hyg. 2004;71:167–72.PubMed
36.
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.PubMed
37.
Danquah I, Dietz E, Zanger P, Reither K, Ziniel P, Bienzle U, et al. Reduced efficacy of intermittent preventive treatment of malaria in malnourished children. Antimicrob Agents Chemother. 2009;53:1753–9.PubMedCentralCrossRefPubMed
38.
Arinaitwe E, Gasasira A, Verret W, Homsy J, Wanzira H, Kakuru A, et al. The association between malnutrition and the incidence of malaria among young HIV-infected and -uninfected Ugandan children: a prospective study. Malar J. 2012;11:90.PubMedCentralCrossRefPubMed
39.
Alexandre MAA, Benzecry SG, Siqueira AM, Vitor-Silva S, Melo GC, Monteiro WM, et al. The association between nutritional status and malaria in children from a rural community in the Amazonian Region: a longitudinal study. PLoS Negl Trop Dis. 2015;9:e0003743.PubMedCentralCrossRefPubMed
40.
Rowland MG, Cole TJ, Whitehead GG. A quantitative study into the role of infection in determining nutritional status in Gambian village children. Br J Nutr. 1977;37:441–50.CrossRefPubMed
41.
Hautvast JL, Tolboom JJ, Kafwembe EM, Musonda RM, Mwanakasale V, van 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.PubMed
42.
Friedman JF, Kurtis JD, Mtalib R, Opollo M, Lanar DE, Duffy PE. Malaria is related to decreased nutritional status among male adolescents and adults in the setting of intense perennial transmission. J Infect Dis. 2003;188:449–57.CrossRefPubMed
43.
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.CrossRefPubMed
44.
Kang H, Kreuels B, Adjei O, Krumkamp R, May J, Small DS. The causal effect of malaria on stunting: a Mendelian randomization and matching approach. Int J Epidemiol. 2013;42:1390–8.CrossRefPubMed
45.
Olney DK, Kariger PK, Stoltzfus RJ, Khalfan SS, Ali NS, Tielsch JM, et al. Developmental effects of micronutrient supplementation and malaria in zanzibari children. Early Hum Dev. 2013;89:667–74.CrossRefPubMed
46.
Muhangi L, Lule SA, Mpairwe H, Ndibazza J, Kizza M, Nampijja M, et al. Maternal HIV infection and others factors associated with growth outcomes of HIV-uninfected infants in Entebbe, Uganda. Publ Health Nutr. 2013;16:1548–57.CrossRef
47.
Padonou G, Le Port A, Cottrell G, Guerra J, Choudat I, Rachas A, et al. Factors associated with growth patterns from birth to 18 months in a Beninese cohort of children. Acta Trop. 2014;135:1–9.CrossRefPubMed
48.
Centers for Disease Control and Prevention. National Center for Health Statistics. CDC growth charts: United States. Hyaltsville: CDC; 2000. p. 2002.
49.
Pelletier DL, Low JW, Johnson FC, Msukwa LA. Child anthropometry and mortality in Malawi: testing for effect modification by age and length of follow-up and confounding by socioeconomic factors. J Nutr. 1994;124:2082S–105S.PubMed
50.
Murray MJ, Murray NJ, Murray AB, Murray MB. Refeeding-malaria and hyperferraemia. Lancet. 1975;1:653–4.CrossRefPubMed
51.
Murray MJ, Murray AB, Murray MB, Murray CJ. Somali food shelters in the Ogaden famine and their impact on health. Lancet. 1976;1:1283–5.CrossRefPubMed
52.
Shankar AH. Nutritional modulation of malaria morbidity and mortality. J Infect Dis. 2000;182:37–53.CrossRef
53.
Ray AP. Haematological studies on Simian malaria. II. Blood picture in monkeys during acute and chronic stages of P. knowlesi infection. Indian J Malariol. 1957;4:360.
54.
Platt BS, Dema IS, Miller DS. Effect of protein values of the diet on the course of malarial infection (Plasmodium berghei) in rats. Proc Nutr Soc. 1960;19:xi.
55.
Ramakrishnan SP. Studies on Plasmodium berghei, Vincke and Lips, 1948. XVII. Effect of different quantities of the same diet on the course of blood-induced infection in rats. Indian J Malariol. 1954;8:89–96.PubMed
56.
Caulfield LE, de Onis M, Blössner M, Black RE. Undernutrition as an underlying cause of child deaths associated with diarrhea, pneumonia, malaria, and measles. Am J Clin Nutr. 2004;80:193–8.PubMed
57.
Bazaz-Malik G, Tatke M. Response to Plasmodium cynomolgi infection in a protein deficient host. Indian J Med Res. 1982;76:527–33.PubMed
58.
Edington GM. Cerebral malaria in the Gold Coast African: four autopsy reports. Ann Trop Med Parasitol. 1954;48:300–6.PubMed
59.
Pelletier DL. The relationship between child anthropometry and mortality in developing countries: implications for policy, programs and future research. J Nutr. 1994;124:2047S–81S.PubMed
60.
Fagbenro-Beyioku AF, Oyerinde JPO. Effect of host-diet inadequacy on the course of infection of Plasmodium yoelii nigeriensis. West Afr J Med. 1990;9:124–8.PubMed
61.
Mfonkeu JB, Gouado I, Kuaté HF, Zambou O, Combes V, Grau GE, et al. Biochemical markers of nutritional status and childhood malaria severity in Cameroon. Br J Nutr. 2010;104:886–92.CrossRefPubMed
62.
Shetty P. Measures of nutritional status from anthropometic survey data. Food and Agriculture Organization of the United Nations: measurement and assessment of food deprivation and undernutrition; 2003. pp 427.
63.
Ntab B, Cissé B, Boulanger D, Sokhna C, Targett G, Lines J, et al. Impact of intermittent preventive anti-malarial treatment on the growth and nutritional status of preschool children in rural Senegal (West Africa). Am J Trop Med Hyg. 2007;77:411–7.PubMedCentralPubMed
64.
de Onis M, Onyango AW, Borghi E, Garza C, Yang H, WHO Multicentre Growth Reference Study Group. Comparison of the World Health Organization (WHO) child growth standards and the National Center for Health Statistics/WHO international growth reference: implications for child health programmes. Public Health Nutr. 2006;9:942–7.PubMed
65.
Lacerda MV, Fragoso SC, Alecrim MG, Alexandre MA, Magalhães BM, Siqueira AM, et al. Postmortem characterization of patients with clinical diagnosis of Plasmodium vivax malaria: to what extent does this parasite kill? Clin Infect Dis. 2012;55:67–74.CrossRef
66.
Anstey N, Douglas MD, Poespoprodjo JR, Price RN. Plasmodium vivax: clinical spectrum, risk factors and pathogenesis. Adv Parasitol. 2012;80:151–201.CrossRefPubMed
67.
Tracey KJ, Cerami A. Tumor necrosis factor in the malnutrition (cachexia) of infection and cancer. Am J Trop Med Hyg. 1992;47:2–7.PubMed
68.
Arnalich F, Martinez P, Hernanz A, González J, Plaza MA, Montiel C, et al. Altered concentrations of appetite regulators may contribute to the development and maintenance of HIV-associated wasting. AIDS. 1997;11:1129–34.CrossRefPubMed
69.
70.
Mueller I, Galinski MR, Baird JK, Carlton JM, Kochar DK, Alonso PL, et al. Key gaps in the knowledge of Plasmodium vivax, a neglected human malaria parasite. Lancet Infect Dis. 2009;9:555–66.CrossRefPubMed
Metadata
Title
Association between anthropometry-based nutritional status and malaria: a systematic review of observational studies
Authors
Efrem d’Avila Ferreira
Márcia A. Alexandre
Jorge L. Salinas
André M. de Siqueira
Silvana G. Benzecry
Marcus V. G. de Lacerda
Wuelton M. Monteiro
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Malaria Journal / Issue 1/2015
Electronic ISSN: 1475-2875
DOI
https://doi.org/10.1186/s12936-015-0870-5

Other articles of this Issue 1/2015

Malaria Journal 1/2015 Go to the issue

Research

A qualitative study of perceptions of a mass test and treat campaign in Southern Zambia and potential barriers to effectiveness

Research

Specific expression and export of the Plasmodium falciparum Gametocyte EXported Protein-5 marks the gametocyte ring stage

Research

Implementation of the integrated management of childhood illness with parasitological diagnosis of malaria in rural Ghana: health worker perceptions

Research

Absence of association between Plasmodium falciparum small sub-unit ribosomal RNA gene mutations and in vitro decreased susceptibility to doxycycline

Meeting report

Global Call to Action to scale-up coverage of intermittent preventive treatment of malaria in pregnancy: seminar report

Research

Patient adherence to prescribed artemisinin-based combination therapy in Garissa County, Kenya, after three years of health care in a conflict setting
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

Watch now

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits