ICMR-National Institute of Malaria Research, New Delhi, India.
Academy of Scientific and Innovative Research, Ghaziabad, Uttar Pradesh, India.
BMJ Glob Health. 2023 Jan;8(1). doi: 10.1136/bmjgh-2022-010781.
Malaria and malnutrition are key public health challenges in India. However, the relationship between them is poorly understood. Here, we aimed to elucidate the potential interactions between the two health conditions by identifying the areas of their spatial overlap.
We have analysed the district-wise undernutrition and malaria data of 638 districts of India across 28 states and 8 union territories. Data on malnutrition parameters viz. stunting, wasting, underweight and anaemia, sourced from the fourth National Family Health Survey (2015-2016), and malaria Annual Parasite Index (API) data of the same year (i.e, 2015), sourced from National Center of Vector Borne Diseases Control were analysed using local Moran's I Index and logistic regression.
Among all the malnutrition parameters, we found underweight in children and anaemia in men to co-occur with malaria in the districts of Chhattisgarh, Jharkhand, Madhya Pradesh and Odisha. Further, districts with more than 36% underweight children (OR (95% CI): 2.31 (1.53 to 3.48)) and/or more than 23.6% male population with anaemia (OR (95% CI): 2.06 (1.37 to 3.11)) had higher odds of being malaria endemic districts (ie, Annual Parasite Index >1).
Malaria and malnutrition co-occur in the malaria-endemic parts of India. The high prevalence of undernutrition in children and anaemia among men may contribute to malaria endemicity in a particular region. Therefore, future research should be prioritised to generate data on the individual level. Further, malaria control interventions could be tailored to integrate nutrition programmes to disrupt indigenous malaria transmission in endemic districts.
疟疾和营养不良是印度主要的公共卫生挑战。然而，它们之间的关系尚未得到充分理解。在这里，我们旨在通过确定两者在空间上的重叠区域来阐明这两种健康状况之间的潜在相互作用。
我们分析了印度 28 个邦和 8 个联邦属地的 638 个地区的营养不良和疟疾数据。营养参数（即发育迟缓、消瘦、体重不足和贫血）的数据来自于第四次国家家庭健康调查（2015-2016 年），同年的疟疾年寄生虫指数（API）数据来自国家媒介传播疾病控制中心，使用局部 Moran's I 指数和逻辑回归进行分析。
在所有的营养参数中，我们发现恰蒂斯加尔邦、贾坎德邦、中央邦和奥里萨邦的儿童体重不足和男性贫血与疟疾同时发生。此外，儿童体重不足超过 36%（比值比（95%置信区间）：2.31（1.53 至 3.48））和/或男性人口贫血超过 23.6%（比值比（95%置信区间）：2.06（1.37 至 3.11））的地区更有可能成为疟疾流行地区（即年寄生虫指数>1）。
印度疟疾流行地区同时存在疟疾和营养不良。儿童中营养不良的高患病率和男性中贫血的高发率可能导致特定地区疟疾流行。因此，应优先进行未来的研究，以生成个人层面的数据。此外，疟疾控制干预措施可以定制整合营养方案，以打破流行地区的本土疟疾传播。
