Dataset Information

Malaria and Malnutrition: Kwashiorkor Associated with Low Levels of Parasitaemia.

ABSTRACT:

Background

The relationship between protein energy malnutrition (PEM) and malaria is controversial. While most studies demonstrate that PEM is associated with greater malaria morbidity, some indicate that PEM may in fact have a protective effect. PEM is differentiated into three subgroups: kwashiorkor (marked protein deficiency), marasmus (calorie deficiency), and kwashiorkor/marasmus. None of the studies concerning PEM and malaria seem to distinguish between these subgroups, and significant differences in susceptibility to malaria between these subgroups may have been overlooked. Plasmodium parasites and malaria infected erythrocytes are sensitive to oxidative stress. Since kwashiorkor patients seem to display an excess of prooxidants and as serum albumin is an important antioxidant, we hypothesized that patients with different forms of PEM might have different levels of malaria parasitaemia.

Methods

72 PEM children older than 6 months admitted to Kwale Family Life Training Programme (Kenya) were included in the study.

Results

Mean parasitaemia was significantly lower in the kwashiorkor group than in the marasmus group (p < 0,001). There was no correlation between serum albumin and parasitaemia.

Conclusion

Our study suggests a protective effect of kwashiorkor against malaria, warranting further studies.

SUBMITTER: Fevang P

PROVIDER: S-EPMC6247571 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Publications

Malaria and Malnutrition: Kwashiorkor Associated with Low Levels of Parasitaemia.

Fevang Per P Havemann Kirsten K Fevang Børre B Høstmark Arne T AT

Malaria research and treatment 20180927

<h4>Background</h4>The relationship between protein energy malnutrition (PEM) and malaria is controversial. While most studies demonstrate that PEM is associated with greater malaria morbidity, some indicate that PEM may in fact have a protective effect. PEM is differentiated into three subgroups: kwashiorkor (marked protein deficiency), marasmus (calorie deficiency), and kwashiorkor/marasmus. None of the studies concerning PEM and malaria seem to distinguish between these subgroups, and signifi ...[more]

PMID: 30533212

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Project description:OBJECTIVE:Plasmodium falciparum is epileptogenic and in malaria endemic areas, is a leading cause of acute seizures. In these areas, asymptomatic infections are common but considered benign and so, are not treated. The effects of such infections on seizures in patients with epilepsy is unknown. This study examined the relationship between P. falciparum infection and seizure control in children with a unique epilepsy type, the nodding syndrome. DESIGN:This cross-sectional study was nested in an ongoing trial 'Doxycycline for the treatment of nodding syndrome (NCT02850913)'. We hypothesised that, in patients with epilepsy, infection by P. falciparum, including asymptomatic infections, increases the risk of seizures and impairs seizure control. SETTING AND PARTICIPANTS:Participants were Ugandan children with nodding syndrome, age ?8 years, receiving sodium valproate. All had standardised testing including documentation of the number of seizures in the past month, a rapid malaria test and if positive, the peripheral blood parasite density. OUTCOMES:The primary outcome was the number of seizures in the past month (30 days). RESULTS:A total of 164/240 (68%) had malaria. Asymptomatic infections (without fever) were seen in 160/240 (67%) and symptomatic infections in 4/240 (2.7%). In participants without malaria, the median (IQR) number of seizures in the past month was 2.0 (1.0-4.0) and it was 4.0 (2.0-7.5) in participants with malaria, p=0.017. The number of seizures in asymptomatic persons was 3.0 (IQR 2.0-7.3) and 6.0 (IQR 4.0-10.0) in symptomatic individuals, p=0.024. Additionally, in asymptomatic patients, a positive correlation was observed between the parasite density and number of seizures, r=0.33, p=0.002. CONCLUSION:In patients with nodding syndrome, both asymptomatic and symptomatic malaria are associated with an increased risk of seizures and poorer seizure control. Similar effects should be examined in other epilepsy disorders. Malaria prevention should be strengthened for these patients and chemotreatment and prevention studies considered to improve seizure control.

Dataset Information

Malaria and Malnutrition: Kwashiorkor Associated with Low Levels of Parasitaemia.

Background

Methods

Results

Conclusion

Publications

Malaria and Malnutrition: Kwashiorkor Associated with Low Levels of Parasitaemia.

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