Friedman Jennifer F, Kurtis Jonathan D, Mtalib Ramadhan, Opollo Malachi, Lanar David E, Duffy Patrick E
United States Department of State, Institute of International Education, Fulbright Fellowships, Washington, DC, USA.
J Infect Dis. 2003 Aug 1;188(3):449-57. doi: 10.1086/376596. Epub 2003 Jul 15.
We studied the impact of Plasmodium falciparum on nutritional status in a longitudinal cohort of 147 young men in western Kenya, where malaria transmission is intense and perennial. All volunteers received treatment to eradicate parasitemia and then provided weekly blood smears during a 16-week transmission season. We measured body mass index (BMI), pubertal development, frequency and density of parasitemia, and tumor necrosis factor (TNF)-alpha production by peripheral blood mononuclear cells. During early puberty, mean parasite density had a strong negative effect on the natural increase in BMI. Among older individuals, TNF-alpha production in response to malarial antigen predicted a significantly lower BMI (P<.03), equal to 4.6 kg for a man of average height. Our data indicate that burden of parasitemia has a detrimental effect on the nutritional status of early adolescents and that malaria may continue to influence nutritional status among older adolescents and adults via host elaboration of proinflammatory cytokines. These effects of malaria may have pervasive health and socioeconomic consequences in areas where malaria is endemic.
我们在肯尼亚西部一个有147名年轻男性的纵向队列中研究了恶性疟原虫对营养状况的影响，该地区疟疾传播强烈且常年流行。所有志愿者都接受了清除寄生虫血症的治疗，然后在16周的传播季节每周提供血涂片。我们测量了体重指数（BMI）、青春期发育、寄生虫血症的频率和密度，以及外周血单核细胞产生肿瘤坏死因子（TNF）-α的情况。在青春期早期，平均寄生虫密度对BMI的自然增长有强烈的负面影响。在年龄较大的个体中，对疟疾抗原产生的TNF-α预示着BMI显著降低（P<0.03），对于平均身高的男性来说，相当于降低4.6千克。我们的数据表明，寄生虫血症负担对青少年早期的营养状况有不利影响，并且疟疾可能通过宿主产生促炎细胞因子继续影响年龄较大的青少年和成年人的营养状况。在疟疾流行地区，疟疾的这些影响可能会对健康和社会经济产生广泛的后果。
