title: Malaria is related to decreased nutritional status among male adolescents and adults in the setting of intense perennial transmission.
abstract: 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.
authors.affiliation: United States Department of State, Institute of International Education, Fulbright Fellowships, Washington, DC, USA.
authors.forename: Jennifer F
authors.initials: JF
authors.lastname: Friedman
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Kurtis
authors.forename: Ramadhan
authors.initials: R
authors.lastname: Mtalib
authors.forename: Malachi
authors.initials: M
authors.lastname: Opollo
authors.forename: David E
authors.initials: DE
authors.lastname: Lanar
authors.forename: Patrick E
authors.initials: PE
authors.lastname: Duffy
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D015992:Body Mass Index; D015331:Cohort Studies; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D007963:Leukocytes, Mononuclear / Q000276:immunology; D016778:Malaria, Falciparum / Q000150:complications* / Q000453:epidemiology / Q000276:immunology; D008297:Male; D015999:Multivariate Analysis; D009748:Nutrition Disorders / Q000453:epidemiology / Q000209:etiology*; D009752:Nutritional Status; D018512:Parasitemia; D010963:Plasmodium falciparum / Q000276:immunology / Q000302:isolation & purification; D011627:Puberty; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
chemical_list: D014409:Tumor Necrosis Factor-alpha