Good diet 'can prevent malaria in children'
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Mike Shanahan
15 September 2004
Source: SciDev.Net
http://www.scidev.net/News/index.cfm?fuseaction=readNews&itemid=1601&language=1
Dietary deficiencies are responsible for "a substantial propor-
tion" of malaria-related sickness and death among children, ac-
cording to researchers at the Johns Hopkins Bloomberg School of
Public Health.
The researchers say that a lack of vitamins and minerals are to
blame for the high numbers of children who fall prey to malaria,
especially in sub-Saharan Africa. They say that many of these
deaths are "entirely preventable", and recommend that nutrition
programmes be integrated into existing malaria prevention
strategies.
The team, led by Laura Caulfield, an associate professor at the
school's Centre for Human Nutrition, reviewed data from Ghana,
Guinea-Bissau and Senegal, and found a strong link between mal-
nourishment and the likelihood of malaria being fatal in chil-
dren under the age of five.
Even mildly malnourished children were twice as likely to die
from malaria than children who are not undernourished, and mod-
erately malnourished children were four times more likely to
die. For children with severe malnutrition, the risk of death
from malaria was nine times greater than in those who were well
nourished.
The researchers say that deficiencies in dietary iron, zinc, vi-
tamin A and folic acid appear to increase the threat that ma-
laria poses to child health. These vitamins and minerals are im-
portant to the human body's immune system, but are often scarce
in areas where malaria is rife.
The researchers estimate that zinc and vitamin A deficiencies in
children under five may each be responsible for about 20 per
cent of malaria deaths in that age group every year a total
of nearly 400,000 deaths. Ninety per cent of the deaths due to
vitamin A deficiency are in Africa, they say.
Until now, scientists have disagreed about whether being under-
nourished makes malaria worse, better or has no effect. Indeed
some studies have even suggested being undernourished protects
individuals from malaria by making them unattractive hosts for
the malaria parasite.
But the new research suggests that being well nourished enables
children to mount a strong immune response and beat the infec-
tion.
However, Caulfield's team warns that famine victims may also be
exposed to increased risks from malaria by re-feeding pro-
grammes. Such programmes, they say, allow the malaria parasite
to multiply more rapidly in the body than the restoration of the
individual's ability to resist the disease.
"In famine relief, it is recommended that malaria chemoprophy-
laxis is provided at the time of re-feeding and that the popula-
tion is monitored carefully for malaria and provided with appro-
priate treatment," write the researchers.
The research by Caulfield and colleagues is one of 37 papers
published in a special supplement of the American Journal of
Tropical Medicine and Hygiene.
The supplement, which is being made available worldwide for no
cost, is called The Intolerable Burden of Malaria II: What's
New, What's Needed. It gathers research on malaria from around
the globe and features papers on anti-malaria drugs, insecticide
treated nets, and other approaches to malaria control in use or
development.
"This supplement comes at a critical time when agencies around
the world are working harder than ever to find new solutions to
the seemingly intractable problem of malaria," says Sharon
Hrynkow, acting director of the Fogarty International Centre,
which led the development of the publication.
Each year, malaria kills between one and two million people,
mostly in sub-Saharan Africa.
Link to full paper by Caulfield et al in the American Journal of
Tropical Medicine and Hygiene:
http://www.ajtmh.org/cgi/content/full/71/2_suppl/55?maxtoshow=&H
ITS=10&hits=10&RESULTFORMAT=&author1=Caulfield&searchid=10951690
42715_527&stored_search=&FIRSTINDEX=0&sortspec=relevance&journal
code=tromped
(copy as one-line URL into your browser)
Link to full text of The Intolerable Burden of Malaria II:
What's New, What's Needed:
http://www.ajtmh.org/content/vol71/2_suppl/index.shtml
Researchers interested in receiving a hard copy of the journal
supplement or the associated DVD should contact the Fogarty In-
ternational Centre (FIC) Communications Office
mailto:ficinfo@nih.gov
Reference: American Journal of Tropical Medicine and Hygiene 71
(Suppl. 2), 55 (2004)