A scoping review on the associations and potential pathways between malnutrition and measles

Abstract

Amid a measles resurgence worldwide, many affected regions also find themselves in circumstances of conflict, humanitarian or political crises, climate extremes, ongoing pandemic challenges, income inequality and economic downturns. Those contextual factors have driven increases in worldwide undernourishment over the past year. The overlap and frequent occurrence of those socio-structural determinants in fragile geographies is worrying as a synergistic relationship between measles and malnutrition has been reported. A scoping review was conducted to map current evidence and identify research gaps on the association between malnutrition and measles. Sixty-seven studies were retained following a search of multiple databases, snowballing and consultations with experts. Studies reported on a measure of association, a relationship, or potential mechanisms behind the link between malnutrition and measles. Overall, there was evidence of a positive correlation between undernutrition and reported measles incidence and mortality. All studies reviewed found an association between vitamin A deficiency and increased likelihood of incident measles, measles-related complications and measles-related deaths. Available evidence also suggested that therapeutic vitamin A can significantly reduce the odds of measles-related mortality, and preventative vitamin A can reduce reported measles incidence. Little data shed light on potential pathways behind malnutrition and measles. Inconsistent variable definitions (i.e. malnutrition and measles cases) across studies precluded calculating a cumulative effect size, and findings may be impacted by uncontrolled confounding factors. This scoping review reinforces the hypothesis of a synergistic relationship between measles and malnutrition and highlights the need for an integrated approach to the delivery of malnutrition interventions and measles prevention and control. In addition, further robust studies are needed to better define pathophysiological targets for interventions and allow for stronger inferences to policy making. Future research should also consider using a standardized approach to defining malnutrition and measles to ensure comparability of outcomes across studies.

Para uma melhor imunidade: abordagem de curso de vida para uma longevidade saudável

“…Por exemplo, há uma associação bem documentada entre a deficiência de vitamina A devido à desnutrição e o aumento da probabilidade de incidência de sarampo e de complicações e mortes relacionadas ao sarampo (60). Altas taxas de cobertura de vacinação nesses subgrupos são especialmente importantes para reduzir a morbimortalidade entre pessoas que já estão predispostas a resultados negativos de saúde devido à sua situação de vida.…”

Lograr una mejor inmunidad: el enfoque de curso de vida para una longevidad saludable

“…Estos determinantes pueden ser la falta de acceso a servicios esenciales (por ejemplo, agua potable, atención de salud), saneamiento (por ejemplo, letrinas), alimentos o seguridad. Por ejemplo, hay una asociación bien documentada entre el déficit de vitamina A debido a la desnutrición y una mayor probabilidad de incidencia de sarampión, de complicaciones relacionadas con el sarampión y de muertes relacionadas con el sarampión (60). Alcanzar tasas altas de cobertura de la vacunación en estos grupos tiene especial importancia para reducir la morbilidad y la mortalidad en las personas que tienen ya una predisposición a presentar resultados de salud desfavorables debido a su situación de vulnerabilidad.…”

Partially Fermented African Locust Bean (Parkia biglobosa) Meal on Laying Performance, Blood Profile, Carcass Characteristics and Economic Efficiency of Layer Chickens

“…Protein-energy malnutrition (PEM) and its associated micronutrient deficiencies, continues to be a major health burden in developing countries such as Ghana [9,10]. The gap between the requirements and supply of four conventional feed ingredients: maize, soybean meal, fish meal and meat meal for feeding poultry in Ghana has resulted in high feed cost [11,12].…”