 | Mariken Wit, Matthew Cairns, Yves Daniel Compaoré, Issaka Sagara, Irene Kuepfer, Issaka Zongo, Amadou Barry, Modibo Diarra, Amadou Tapily, Samba Coumare, Ismaila Thera, Frederic Nikiema, R Serge Yerbanga, Rosemonde M Guissou, Halidou Tinto, Alassane Dicko, Daniel Chandramohan, Brian Greenwood, Jean Bosco Ouedraogo Nutritional status in young children prior to the malaria transmission season in Burkina Faso and Mali, and its impact on the incidence of clinical malaria (Journal Article) In: Malar. J., vol. 20, no. 1, pp. 274, 2021, ISSN: 1475-2875, (PMID: 34158054
PMCID: PMC8220741). @article{De_Wit2021-yi,
title = {Nutritional status in young children prior to the malaria transmission season in Burkina Faso and Mali, and its impact on the incidence of clinical malaria},
author = {Mariken Wit and Matthew Cairns and Yves Daniel Compaor\'{e} and Issaka Sagara and Irene Kuepfer and Issaka Zongo and Amadou Barry and Modibo Diarra and Amadou Tapily and Samba Coumare and Ismaila Thera and Frederic Nikiema and R Serge Yerbanga and Rosemonde M Guissou and Halidou Tinto and Alassane Dicko and Daniel Chandramohan and Brian Greenwood and Jean Bosco Ouedraogo},
doi = {10.1186/s12936-021-03802-2},
issn = {1475-2875},
year = {2021},
date = {2021-06-22},
urldate = {2021-06-22},
journal = {Malar. J.},
volume = {20},
number = {1},
pages = {274},
publisher = {Springer Science and Business Media LLC},
abstract = {BACKGROUND: Malaria and malnutrition remain major problems in
Sahel countries, especially in young children. The direct effect
of malnutrition on malaria remains poorly understood, and may
have important implications for malaria control. In this study,
nutritional status and the association between malnutrition and
subsequent incidence of symptomatic malaria were examined in
children in Burkina Faso and Mali who received either
azithromycin or placebo, alongside seasonal malaria
chemoprevention. METHODS: Mid-upper arm circumference (MUAC) was
measured in all 20,185 children who attended a screening visit
prior to the malaria transmission season in 2015. Prior to the
2016 malaria season, weight, height and MUAC were measured among
4149 randomly selected children. Height-for-age, weight-for-age,
weight-for-height, and MUAC-for-age were calculated as
indicators of nutritional status. Malaria incidence was measured
during the following rainy seasons. Multivariable random effects
Poisson models were created for each nutritional indicator to
study the effect of malnutrition on clinical malaria incidence
for each country. RESULTS: In both 2015 and 2016, nutritional
status prior to the malaria season was poor. The most prevalent
form of malnutrition in Burkina Faso was being underweight
(30.5%; 95% CI 28.6-32.6), whereas in Mali stunting was most
prevalent (27.5%; 95% CI 25.6-29.5). In 2016, clinical malaria
incidence was 675 per 1000 person-years (95% CI 613-744) in
Burkina Faso, and 1245 per 1000 person-years (95% CI 1152-1347)
in Mali. There was some evidence that severe stunting was
associated with lower incidence of malaria in Mali (RR 0.81; 95% CI 0.64-1.02; p = 0.08), but this association was not seen
in Burkina Faso. Being moderately underweight tended to be
associated with higher incidence of clinical malaria in Burkina Faso (RR 1.27; 95% CI 0.98-1.64; p = 0.07), while this was the
case in Mali for moderate wasting (RR 1.27; 95% CI 0.98-1.64; p = 0.07). However, these associations were not observed in
severely affected children, nor consistent between countries.
MUAC-for-age was not associated with malaria risk. CONCLUSIONS:
Both malnutrition and malaria were common in the study areas,
high despite high coverage of seasonal malaria chemoprevention
and long-lasting insecticidal nets. However, no strong or
consistent evidence was found for an association between any of
the nutritional indicators and the subsequent incidence of
clinical malaria.},
note = {PMID: 34158054
PMCID: PMC8220741},
keywords = {Acute malnutrition, Antimalarials/administration \& dosage, Azithromycin/administration \& dosage, Burkina Faso, Burkina Faso/epidemiology, Child, Chronic malnutrition, Female, Humans, Incidence, Infant, Malaria, Malaria/epidemiology/transmission, Male, Nutritional Status, Preschool, seasonal malaria chemoprevention, Seasons},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Malaria and malnutrition remain major problems in
Sahel countries, especially in young children. The direct effect
of malnutrition on malaria remains poorly understood, and may
have important implications for malaria control. In this study,
nutritional status and the association between malnutrition and
subsequent incidence of symptomatic malaria were examined in
children in Burkina Faso and Mali who received either
azithromycin or placebo, alongside seasonal malaria
chemoprevention. METHODS: Mid-upper arm circumference (MUAC) was
measured in all 20,185 children who attended a screening visit
prior to the malaria transmission season in 2015. Prior to the
2016 malaria season, weight, height and MUAC were measured among
4149 randomly selected children. Height-for-age, weight-for-age,
weight-for-height, and MUAC-for-age were calculated as
indicators of nutritional status. Malaria incidence was measured
during the following rainy seasons. Multivariable random effects
Poisson models were created for each nutritional indicator to
study the effect of malnutrition on clinical malaria incidence
for each country. RESULTS: In both 2015 and 2016, nutritional
status prior to the malaria season was poor. The most prevalent
form of malnutrition in Burkina Faso was being underweight
(30.5%; 95% CI 28.6-32.6), whereas in Mali stunting was most
prevalent (27.5%; 95% CI 25.6-29.5). In 2016, clinical malaria
incidence was 675 per 1000 person-years (95% CI 613-744) in
Burkina Faso, and 1245 per 1000 person-years (95% CI 1152-1347)
in Mali. There was some evidence that severe stunting was
associated with lower incidence of malaria in Mali (RR 0.81; 95% CI 0.64-1.02; p = 0.08), but this association was not seen
in Burkina Faso. Being moderately underweight tended to be
associated with higher incidence of clinical malaria in Burkina Faso (RR 1.27; 95% CI 0.98-1.64; p = 0.07), while this was the
case in Mali for moderate wasting (RR 1.27; 95% CI 0.98-1.64; p = 0.07). However, these associations were not observed in
severely affected children, nor consistent between countries.
MUAC-for-age was not associated with malaria risk. CONCLUSIONS:
Both malnutrition and malaria were common in the study areas,
high despite high coverage of seasonal malaria chemoprevention
and long-lasting insecticidal nets. However, no strong or
consistent evidence was found for an association between any of
the nutritional indicators and the subsequent incidence of
clinical malaria. |
