Biochemical markers of nutritional status and childhood malaria severity in Cameroon.
To investigate the part played by undernutrition in malaria severity, some biomarkers of nutritional status were assessed in children with severe malarial anaemia (MA) and cerebral malaria (CM) in comparison with healthy children or those with uncomplicated malaria. Undernutrition was assessed using the weight-for-age Z score (WAZ). Retinol was determined by HPLC; lipid profile, Ca, Mg and albumin were determined by spectrophotometry. Severe and moderate undernutritions were more prevalent in children with MA and those with the combined symptoms of CM and MA, but not in those with CM alone. Some perturbations were noticed in the lipid profile, but most of the values remained within the normal ranges. The risk of vitamin A deficiency, as assessed by plasma retinol concentration, was noteworthy in children with severe malaria: 0.48 × 10(-6) and 0.50 × 10(-6) mol/l, respectively, in children with MA and CM (reference value: >0.7 × 10(-6) mol/l). A significant difference was obtained for retinol values after an ANOVA of all the groups (P = 0.0029), with the value in the MA group being significantly low than that in the control group (P < 0.05); likewise, a significant difference was obtained after comparison of all the groups for Mg and albumin (P = 0.0064 and 0.0082, respectively). Despite their low number (n 6), fatal cases of CM had a normal mean WAZ on admission, but low values of retinol, albumin and HDL:LDL ratio. Despite these associations, undernutrition itself did not appear to be a primary factor associated with fatal outcome.
Mfonkeu
Joël Bertrand Pankoui
JB
Department of Biochemistry, Faculty of Science, University of Douala, PO Box 24157, Douala, Cameroon.
Gouado
Inocent
I
Kuaté
Honoré Fotso
HF
Zambou
Odile
O
Combes
Valéry
V
Grau
Georges Emile Raymond
GE
Zollo
Paul Henri Amvam
PH
D000418:Albumins / Q000378:metabolism; D000704:Analysis of Variance; D000740:Anemia / Q000097:blood* / Q000209:etiology; D015415:Biomarkers / Q000097:blood*; D001835:Body Weight; D002163:Cameroon / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood; D008274:Magnesium / Q000097:blood; D008288:Malaria / Q000097:blood / Q000150:complications* / Q000401:mortality; D016779:Malaria, Cerebral / Q000097:blood* / Q000150:complications / Q000401:mortality; D008297:Male; D044342:Malnutrition / Q000097:blood* / Q000150:complications / Q000453:epidemiology; D009752:Nutritional Status; D015995:Prevalence; D012016:Reference Values; D012307:Risk Factors; D012720:Severity of Illness Index; D014801:Vitamin A / Q000097:blood; D014802:Vitamin A Deficiency / Q000097:blood / Q000150:complications
D000418:Albumins; D015415:Biomarkers; D008055:Lipids; D014801:Vitamin A; D008274:Magnesium