Francis I. Proctor Foundation, University of California, San Francisco.
Department of Ophthalmology, University of California, San Francisco.
Clin Infect Dis. 2018 Sep 14;67(7):1027-1034. doi: 10.1093/cid/ciy207.
The relationship between malaria infection and nutritional status is complex. Previous studies suggest malaria may increase the incidence and severity of malnutrition, while malnutrition may increase the risk of malaria infection. Here, we report bidirectional associations between malaria and nutritional status among children with uncomplicated severe acute malnutrition (SAM).
This study is a secondary analysis of a randomized, controlled trial for the treatment of uncomplicated SAM in Niger. Children aged 6-59 months were enrolled and followed for 12 weeks. Malaria infection was assessed using an histidine-rich protein 2 (HRP2) rapid diagnostic test at admission and at any follow-up visit with fever. We assessed the association of nutritional status at admission on malaria incidence using Cox proportional hazards regression and malaria infection at admission on nutritional recovery and weight and height gain using linear regression.
Of 2399 children included in the analysis, 1327 (55.3%) were infected with malaria at admission. Malaria incidence was 12.1 cases/100 person-months among those without malaria infection at admission. Nutritional status at admission was not associated with malaria incidence. Children with malaria infection at admission and subsequently treated with an artemisinin-based combination therapy had increased weight gain (0.38 g/kg/day; 95% confidence interval [CI], 0.07 to 0.69) and reduced height gain (-0.002 mm/day; 95% CI, -0.004 to -0.0008).
Malaria infection was common among children treated for uncomplicated SAM. Malaria infection may impair height gain. Proper medical and nutritional management should be ensured to prevent adverse effects of malaria infection.
NCT01613547.
疟疾感染与营养状况之间的关系很复杂。先前的研究表明，疟疾可能会增加营养不良的发生率和严重程度，而营养不良可能会增加疟疾感染的风险。在这里，我们报告了无并发症严重急性营养不良（SAM）儿童中疟疾与营养状况之间的双向关联。
这是一项在尼日尔进行的无并发症 SAM 治疗的随机对照试验的二次分析。6-59 月龄的儿童入组并随访 12 周。在入院时和任何有发热的随访就诊时使用 HRP2 快速诊断检测评估疟疾感染。我们使用 Cox 比例风险回归评估入院时的营养状况与疟疾发病率的关系，使用线性回归评估入院时的疟疾感染与营养恢复以及体重和身高增长的关系。
在分析中纳入的 2399 名儿童中，1327 名（55.3%）在入院时感染了疟疾。在入院时没有疟疾感染的儿童中，疟疾发病率为 12.1 例/100 人月。入院时的营养状况与疟疾发病率无关。入院时患有疟疾感染并随后接受青蒿素为基础的联合疗法治疗的儿童体重增加（0.38 g/kg/天；95%置信区间[CI]，0.07 至 0.69），身高增长减少（-0.002 mm/天；95%CI，-0.004 至-0.0008）。
在接受无并发症 SAM 治疗的儿童中，疟疾感染很常见。疟疾感染可能会损害身高增长。应确保进行适当的医疗和营养管理，以预防疟疾感染的不良影响。
NCT01613547。
