Exploring the relationship between chronic undernutrition and asymptomatic malaria in Ghanaian children.
BACKGROUND
A moderate association has been found between asymptomatic parasitaemia and undernutrition. However, additional investigation using the gold standard for asymptomatic parasitaemia confirmation, polymerase chain reaction (PCR), is needed to validate this association. Anthropometric measurements and blood samples from children less than five years of age in a rural Ghanaian community were used to determine if an association exists between chronic undernutrition and PCR-confirmed cases of asymptomatic malaria.


METHODS
This was a descriptive cross-sectional study of 214 children less than five years of age from a community near Kumasi, Ghana. Blood samples and anthropometric measurements from these children were collected during physical examinations conducted in January 2007 by partners of the Barekuma Collaborative Community Development Programme.


RESULTS
Findings from the logistic model predicting the odds of asymptomatic malaria indicate that children who experienced mild, moderate or severe stunting were not more likely to have asymptomatic malaria than children who were not stunted. Children experiencing anaemia had an increased likelihood (OR = 4.15; 95% CI: 1.92, 8.98) of asymptomatic malaria. Similarly, increased spleen size, which was measured by ultrasound, was also associated with asymptomatic malaria (OR = 2.17; 95% CI: 1.44, 3.28). Fast breathing, sex of the child, and age of the child were not significantly associated with the asymptomatic malaria.


CONCLUSIONS
No significant association between chronic undernutrition and presence of asymptomatic malaria was found. Children who experience anaemia and children who have splenomegaly are more likely to present asymptomatic malaria. Programmes aimed at addressing malaria should continue to include nutritional components, especially components that address anaemia.
Crookston
Benjamin T
BT
Department of Family and Preventive Medicine, University of Utah, 375 Chipeta Way, Salt Lake City, UT 84108, USA. benjamin.crookston@utah.edu
Alder
Stephen C
SC
Boakye
Isaac
I
Merrill
Ray M
RM
Amuasi
John H
JH
Porucznik
Christina A
CA
Stanford
Joseph B
JB
Dickerson
Ty T
TT
Dearden
Kirk A
KA
Hale
Devon C
DC
Sylverken
Justice
J
Snow
Bryce S
BS
Osei-Akoto
Alex
A
Ansong
Daniel
D
D017677:Age Distribution; D000367:Age Factors; D015362:Child Nutrition Disorders / Q000150:complications* / Q000453:epidemiology; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006130:Growth Disorders / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016778:Malaria, Falciparum / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology / Q000469:parasitology; D008297:Male; D044342:Malnutrition / Q000150:complications* / Q000453:epidemiology; D018512:Parasitemia / Q000150:complications / Q000453:epidemiology; D010963:Plasmodium falciparum / Q000302:isolation & purification; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D012307:Risk Factors; D012424:Rural Population; D012737:Sex Factors; D012959:Socioeconomic Factors
D004279:DNA, Viral