Effects of Heavy and Repeated Malarial Infections on Gambian Infants and Children

McGregor, Ian A.; Gilles, H. M.; Walters, Jae; Davies, Alex; Pearson, Freya

doi:10.1136/bmj.2.4994.686

Cited by 189 publications

(63 citation statements)

References 4 publications

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“…Although, anaemia and malaria (McGregor et al, 1956) have both been shown to affect growth, the present study does not support this concept. However, prolonged episodes of malaria and severe anaemia were exceptional during the course of the study and the number of children is small to address such questions.…”

Section: Discussioncontrasting

confidence: 97%

High fat versus high carbohydrate nutritional supplementation: a one year trial in stunted rural Gambian children

1998

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Objective: The study tests the hypothesis that a low daily fat intake may induce a negative fat balance and impair catch-up growth in stunted children between 3 and 9 y of age. Design: Randomized case-control study. Setting: Three rural villages of the West Kiang District, The Gambia. Subjects: Three groups of 30 stunted but not wasted children (height for age z-score 72.0, weight for height zscore ! 7 2.0) 3±9 y of age were selected by anthropometric survey. Groups were matched for age, sex, village, degree of stunting and season. Intervention: Two groups were randomly assigned to be supplemented ®ve days a week for one year with either a high fat (n 29) or a high carbohydrate biscuit (n 30) each containing approximately 1600 kJ. The third group was a non supplemented control group (n 29). Growth, nutritional status, dietary intake, resting energy expenditure and morbidity were compared. Results: Neither the high fat nor the high carbohydrate supplement had an effect on weight or height gain. The high fat supplement did slightly increase adipose tissue mass. There was no effect of supplementation on resting energy expenditure or morbidity. In addition, the annual growth rate was not associated with a morbidity score. Conclusions: Results show that neither a high fat nor a high carbohydrate supplement given during 12 months to stunted Gambian children induced catch-up growth. The authors suggest that an adverse effect of the environment on catch-up growth persists despite the nutritional interventions. Sponsorship: Nestle Â Foundation for the Study of the Problems of Nutrition in the World, Lausanne, Switzerland. Descriptors: stunting; dietary fats; dietary carbohydrates; nutritional supplementation; catch-up growth; energy intake; resting energy expenditure; morbidity IntroductionIn 1983 the prevalence of stunting in children under ®ve years of age in developing countries was estimated using national prevalence values at approximately 40%, yielding a total of 125 million children (Keller, 1988). Ten years later, in a recent WHO report on child growth, the prevalence was estimated at 43% and a total of 230 million children were identi®ed as being stunted (de Onis et al, 1993). These ®gures illustrate the magnitude of the problem of stunting and serve as a reminder of how little is known about its causes in nutritional, metabolic and biochemical terms.Despite access to medical care, young children in Keneba (West Kiang District, Gambia) have repeated infectious episodes with growth faltering followed by inadequate catch-up growth (Rowland et al, 1977). Children gradually become stunted during the ®rst two years of life and tend to remain stunted through childhood into adult life. There is however evidence that stunting can be reversed during infancy and even during late childhood through adoption and to a lesser degree with nutritional supplementation (Martorell et al, 1994). This suggests that catch-up growth is impaired by conditions found in the environment in which the children became stunted. It is well esta...

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Section: Discussioncontrasting

confidence: 97%

High fat versus high carbohydrate nutritional supplementation: a one year trial in stunted rural Gambian children

1998

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“…This indicates that the parasitic load is comparatively less during the primary attack and progressed during further attacks. A similar observation has been reported in children from a malaria endemic area (12). This is attributed to the phenonmenon of malarial tolerance.…”

Section: Methodssupporting

confidence: 85%

Hematological Impairments in Recurrent Plasmodium Vivax Infected Patients

Selvam

Gunasekaran

1996

JJMSB

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SUMMARY:The hematological parameters were assayed in Plasmodium vivax patients with only one infection, two infections, three infections and more than three malarial infections during a period of six months. A steady fall in the levels of hemoglobin as well as packed cell volume (PCV) level was observed with increasing number of infections. The malarial patients showed a progressive decrease in RBC level with increasing number of attacks. The decrease in the hematological indices was statistically significant at all levels of parasitemia. There was a marked increase in the osmotic fragility of the malarial erythrocytes when compared to that of controls. During repeated malarial attacks, significant decrease in MCH (p<0.05) and MCHC (p<0.01) and increase in the MCV level (p <0.05) and Heinz body formation (p<0.001) were observed. Parasite density significantly influenced the fragility of the erythrocytes, Heinz body formation, MCV, MCH and MCHC levels. Thus, the erythrocytes of the patients repeatedly infected with Plasmodium vivax parasite are subjected to structural and functional impairment, ultimately culminating in anemia.

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“…In developing countries, 15% or more of children born each year die before they reach the age of 5 years, mainly due to malnutrition, parasitic infections and low birth weight. Malaria has been shown to impair growth of younger but not older children [18] .…”

Section: Discussionmentioning

confidence: 99%

Serum retinol concentration in patients with acute falciparum malaria

Raza

Khan

Malik

et al. 2009

J Infect Dev Ctries

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Background: Vitamin A (retinol)-deficiency and falciparum malaria are two major public health problems in developing countries. Falciparum malaria is associated with significant destruction of erythrocytes and can lead to severe anaemia. Methodology: The present study was designed to estimate the serum retinol concentration in 150 acute falciparum-malaria patients (aged two to five years) by High Performance Liquid Chromatography (HPLC). Serum retinol concentrations of 20 healthy (age and sex matched, population based) volunteers were included as controls. Results: The mean serum retinol concentration of healthy controls was 34.31 ± 1.274 µg/dl and that of diseased cohort was 12.562 ± 0.276 µg/dl. The mean parasitemia was 1239.2 ± 33.609 per µL. Conclusions: The diseased cohort demonstrated significant reduction in concentrations of retinol in comparison to healthy controls (p < 0.001) and there was an inverse relationship (coefficient of correlation r = -0.899) between parasitemia and serum retinol concentration.

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Effects of Heavy and Repeated Malarial Infections on Gambian Infants and Children

Cited by 189 publications

References 4 publications

High fat versus high carbohydrate nutritional supplementation: a one year trial in stunted rural Gambian children

High fat versus high carbohydrate nutritional supplementation: a one year trial in stunted rural Gambian children

Hematological Impairments in Recurrent Plasmodium Vivax Infected Patients

Serum retinol concentration in patients with acute falciparum malaria

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