Nutritional Modulation of Malaria Morbidity and Mortality

Abstract

This review critically examines the relationship between nutritional status and malaria. The data indicate that protein-energy malnutrition is associated with greater malaria morbidity and mortality in humans. In addition, controlled trials of either vitamin A or zinc supplementation show that these nutrients can substantially reduce clinical malaria attacks. Data for iron indicate that supplementation may minimally aggravate certain malariometric indices in some settings and also strongly improve hematologic status. Withholding of iron supplements from deficient population is, therefore, not currently indicated. Available evidence for other nutrients describe varied effects, with some deficiencies being exacerbative (e.g., thiamine), protective (e.g., vitamin E), or both exacerbative and protective in different settings (e.g., riboflavin, vitamin C). The roles of folate, other B vitamins, unsaturated fatty acids, amino acids, and selenium are also examined. Study of the interactions between nutrition and malaria may provide insight to protective mechanisms and result in nutrient-based interventions as low-cost and effective adjuncts to current methods of malaria prevention and treatment.

Antiplasmodial Effect of a Crude Extract of the Leaves of Xylopia Parviflora (Benth) On Plasmodium Yoelli Infection in Mice Fed Supplemented Dietary Pellets

“…This probably supports other observation that anti-oxidant nutrients such as vitamin E contained in red palm oil as well as protein deficient-diets (kwashiorkor) favour the growth and survival of the malarial parasites [22,23]. Indeed protein energy malnutrition is said to be associated with greater malarial morbidity and mortality [24]. Nonetheless, the influence of red palm oil and other tropical cooking oils on the survival and growth of malarial parasites has been of concern but remains contentious [10] .A possible mechanism of the role of red palm oil on malarial infection have recently been suggested by Yahya and Kadir [25].…”

Evidence for additive and interaction effects of host genotype and infection in malaria

“…One of these associations implicates the SLC39A8 locus, which encodes a zinc transporter protein highly up-regulated in response to primary T-cell activation, especially in the presence of low concentrations of zinc (33). Several studies and initiatives have proposed zinc supplementation as a strategy to help reduce the risk of malaria episodes (34,35), and our data implicate a gene whose action is potentiated by zinc but also clearly and robustly conditioned by host regulatory variation. The interaction implicating SLC39A8 illustrates a robust in vivo genotype-by-infection effect that is directly linked to the key process of T-cell development.…”

Impact of malnutrition on immunity and infection

“…There is experimental evidence that vitamin A supplementation in children is associated with a reduction from 23 to 30% in mortality risk and attenuation in disease severity (59) There is also a general consensus that PEM is associated with greater malaria morbidity and mortality in humans (65). Supporting this observation, controlled clinical trials of either vitamin A or zinc supplementation indicated that these nutrients can substantially reduce clinical malaria outbreaks (66,67).…”