Undernutrition as an Underlying Cause of Malaria Morbidity and Mortality in Children Less Than Five Years Old

Abstract

Undernutrition is highly prevalent in many areas in which morbidity and mortality from malaria is unacceptably high. That undernutrition exacerbates diarrhea and respiratory infections is widely demonstrated; however, research suggests that it may exacerbate, palliate, or have little effect on malaria outcomes. This review examines the global burden of malaria associated with various nutrient deficiencies as well as underweight status in children 0-4 years of age. Although the association is complex and requires additional research, improved nutritional status lessens the severity of malaria episodes and results in fewer deaths due to malaria. Deficiencies in vitamin A, zinc, iron, folate, as well as other micronutrients are responsible for a substantial proportion of malaria morbidity and mortality. It is recommended that nutrition programs be integrated into existing malaria intervention programs.

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). Opinions regarding the effect of certain micronutrients, as iron, for example, are still contradictory (68,56).…”

Anaemia and associated factors among under-fives and their mothers in Bushenyi district, Western Uganda

“…Fe deficiency is known to decrease immune function, but some investigators have also hypothesized that Fe supplementation increases infectious disease (17) . Indeed, some controversy exists concerning Fe-deficiency anaemia in that it does not appear to contribute to growth faltering (18) .…”

Relationship Between Growth Rate and Different Types of Infection in Children Under 5 Years on West Papua

“…A possible explanation is because skin infections do not alter dietary intake as much as respiratory infections or gastroenteritis. Other studies have demonstrated a relationship between malaria and nutrtion, 21,22 but the low number of children in this study that is diagnosed with malaria, with a total of 5 makes it hard to show a significant effect. From the result of this study, regarding nutritional status in children, the focus should not be solely on improving the anthropometry status of children, but to also consider the overall health condition, because upper respiratory tract infections and gastroenteritis is caused by many different factors.…”