Malaria increased the risk of stunting and wasting among young children in Ethiopia: Results of a cohort study

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From: PLoS ONE(Vol. 13, Issue 1)
Publisher: Public Library of Science
Document Type: Report
Length: 6,311 words
Lexile Measure: 1410L

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Author(s): Taye Gari 1,2,*, Eskindir Loha 1, Wakgari Deressa 3, Tarekegn Solomon 1,2, Bernt Lindtjørn 2


Malaria is a public health problem in the developing world; particularly in sub-Saharan African countries where malaria kills a child every two minutes [1]. The disease remains one of the major challenge for people's health and livelihood around the world [1]. On the other hand, malnutrition is an underlying cause of death for approximately 45% of children under the age of five years [2]. Globally, 161 million children under five years old were stunted, and 51 million were wasted in 2012 [3,4]. One-third of the world's stunted children were living in sub-Saharan Africa [5]. Malnutrition could refer both to under- and over-nutrition [6], but in this study we use the term to refer to under-nutrition (stunting, underweight and wasting).

In Ethiopia, malaria is a common cause of childhood illness [1,7].Nearly, 68% of the land mass of the country have ecological characteristics favourable for malaria transmission, and about 60% of the population is at risk of malaria infection [8]. The transmission of malaria is seasonal and unstable [8]. Plasmodium falciparum (60%) and P .vivax (40%) are the two main causes of malaria [9]. According to the recent malaria indicator surveys, the national prevalence of malaria among children was 1.4% in 2011[7] and 0.6% in 2015 [10]. A pilot study conducted for the preparation of a community based malaria prevention trial in Adami Tulu district, Ethiopia (same study area with current study) in 2013, has shown a malaria incidence of 6.8 cases per 10,000 person weeks of observation among children [11]. In addition, under-nutrition is a major public health problem in the country. According to the 2016 Demographic and Health Survey (DHS), 47% of rural children were stunted and 10% were wasted [12-14].

Good nutrition and healthy growth during a period from conception to a child's second birthday-the 1,000 days-have lasting benefits throughout life, and undernourished children reaching this age could suffer from irreversible health problems [15]. Under-nutrition could be the result of poor dietary intake often combined with infectious disease [16]. On the other hand, malnutrition is a well-known underlying cause for many infectious disease-related causes of child deaths [17,18]. Malaria and malnutrition co-exist in a setting where the two conditions are highly prevalent [19]. However, the relationship between malaria and under-nutrition is complex and remains unclear. Previous research shows mixed findings, e.g.: a community-based survey from Ghana showed underweight as a contributing risk to malaria infection [18], whereas results from a follow-up study and repeated cross-sectional surveys showed stunting as a contributing risk to malaria [20]. A case-control study from Ethiopia reported wasting as a contributing risk to malaria [21]. Some cohort studies showed a lower contributing risk to malaria infection among malnourished children [22-24], although results from other cross-sectional surveys did not report any association between malaria and malnutrition [25,26]. Meanwhile, others observed malaria infection as a risk factor for under-nutrition [27-29]. In summary, most of the studies assessing the possible association between...

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Gale Document Number: GALE|A522513262