National Institute for Medical Research, Tanga Centre, Tanga, Tanzania.
Department of Microbiology, Immunology and Parasitology, Hubert Kairuki Memorial University, Dar es Salaam, Tanzania.
PLoS One. 2022 Apr 29;17(4):e0267670. doi: 10.1371/journal.pone.0267670. eCollection 2022.
Malnutrition and malaria are common co-morbidities in low-income countries, especially among under-fives children. But the malnutrition situation in Masasi and Nanyumbu districts, its interaction with malaria infection and the influence of socioeconomic factors are not well understood.
Children aged between 3-59 months in Masasi and Nanyumbu were screened for nutritional status and malaria infection in the community. Nutritional status was determined using age and anthropometric parameters. Z-scores (weight for age (WAZ), height for age (HAZ) and weight for height (WHZ)) were calculated based on the World Health Organisation (WHO) growth reference curves. Malaria infection was determined using malaria rapid diagnostic test and microscopy. Hemoglobin concentration was assessed using HemoCue spectrophotometer, and anemia was classified as hemoglobin concentration < 11.0g/dL. Structured questionnaire was used to collect socio- demographic information electronically.
A total of 2242 children, 1539 (68.6%) from Masasi and 1169 (52.1%) females were involved in the study. The mean z-scores (WAZ = -0.60 and HAZ = -1.56) were lower than the WHO reference population. The overall prevalence of malnutrition was 49%, and it was significantly higher in Nanyumbu (52.5%) than in Masasi (47.3%), (x2 = 5.045, p = 0.025). Prevalence of malnutrition was higher in boys (53.0%) than in girls (45.0%) (x2 = 13.9, p < 0.001). Stunting was the most prevalent component of undernutrition; it was slightly prevalent in Nanyumbu (46.5%) compared to Masasi (42.0%), (x2 = 3.624, p = 0.057) and in boys (48.2%) than in girls (39.1%), x2 = 17.44, p<0.001. Only 15.8% of the undernourished children had malaria infection. Sex, age group and anaemia were significantly associated with undernourishment (p<0.05), while district and malaria infection were marginally (p≤0.06) associated with undernourishment. None of the undernutrition indices was associated with malaria infection.
Undernutrition was highly prevalent in the study population and was influenced sex, age, anaemia and malaria infection. More emphasis is needed to address the malnutrition problem especially stunting in Masasi and Nanyumbu districts.
营养不良和疟疾在低收入国家是常见的合并症，尤其是在五岁以下儿童中。但是，马萨西和南永布地区的营养不良情况、它与疟疾感染的相互作用以及社会经济因素的影响尚不清楚。
在社区中对马萨西和南永布地区 3-59 个月的儿童进行营养状况和疟疾感染筛查。营养状况通过年龄和人体测量参数来确定。根据世界卫生组织（WHO）生长参考曲线，计算出年龄别体重（WAZ）、年龄别身高（HAZ）和身高别体重（WHZ）的 Z 分数。疟疾感染通过疟疾快速诊断检测和显微镜检查确定。血红蛋白浓度使用 HemoCue 分光光度计进行评估，贫血分类为血红蛋白浓度<11.0g/dL。使用电子问卷收集社会人口统计学信息。
共有 2242 名儿童参与了研究，其中 1539 名（68.6%）来自马萨西，1169 名（52.1%）为女性。平均 Z 分数（WAZ=-0.60 和 HAZ=-1.56）低于 WHO 参考人群。营养不良的总体患病率为 49%，南永布的患病率明显更高（52.5%），而马萨西的患病率较低（47.3%）（x2=5.045，p=0.025）。男孩（53.0%）的营养不良患病率高于女孩（45.0%）（x2=13.9，p<0.001）。发育迟缓是营养不良最常见的组成部分；南永布的发育迟缓患病率略高（46.5%），而马萨西的患病率较低（42.0%）（x2=3.624，p=0.057），男孩（48.2%）的发育迟缓患病率高于女孩（39.1%）（x2=17.44，p<0.001）。只有 15.8%的营养不良儿童患有疟疾感染。性别、年龄组和贫血与营养不良显著相关（p<0.05），而地区和疟疾感染与营养不良略有相关（p≤0.06）。没有一个营养不良指标与疟疾感染有关。
营养不良在研究人群中高度流行，受到性别、年龄、贫血和疟疾感染的影响。需要更加重视解决马萨西和南永布地区的营养不良问题，特别是发育迟缓问题。
