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.
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.
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DOI：
10.1186/s12936-021-03802-2
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发表时间：
2021-06-22
期刊：
影响因子：
3
通讯作者：
Ouedraogo JB
中科院分区：
文献类型：
--
作者：
de Wit M;Cairns M;Compaoré YD;Sagara I;Kuepfer I;Zongo I;Barry A;Diarra M;Tapily A;Coumare S;Thera I;Nikiema F;Yerbanga RS;Guissou RM;Tinto H;Dicko A;Chandramohan D;Greenwood B;Ouedraogo JB
疟疾和营养不良仍然是萨赫勒国家的主要问题，特别是对幼儿而言。营养不良对疟疾的直接影响仍然知之甚少，但可能对疟疾控制产生重要影响。在这项研究中，对布基纳法索和马里接受阿奇霉素或安慰剂以及季节性疟疾化学预防的儿童的营养状况以及营养不良与随后的症状性疟疾发病之间的关系进行了检查。对 2015 年疟疾传播季节之前参加筛查访视的所有 20,185 名儿童进行了中上臂围 (MUAC) 测量。在 2016 年疟疾季节之前，对随机选择的 4149 名儿童进行了体重、身高和 MUAC 测量。计算年龄别身高、年龄别体重、身高别体重和年龄别 MUAC 作为营养状况的指标。在接下来的雨季期间测量了疟疾发病率。为每个营养指标创建多变量随机效应泊松模型，以研究营养不良对每个国家临床疟疾发病率的影响。 2015年和2016年，疟疾季节之前的营养状况都很差。布基纳法索最普遍的营养不良形式是体重不足（30.5%；95% CI 28.6-32.6），而在马里，发育迟缓最为普遍（27.5%；95% CI 25.6-29.5）。 2016 年，布基纳法索的临床疟疾发病率为每 1000 人年 675 例（95% CI 613–744），马里的临床疟疾发病率为每 1000 人年 1245 例（95% CI 1152–1347）。有证据表明，马里严重发育迟缓与疟疾发病率较低有关（RR 0.81；95% CI 0.64–1.02；p = 0.08），但在布基纳法索并未发现这种关联。在布基纳法索，中度体重不足往往与较高的临床疟疾发病率相关（RR 1.27；95% CI 0.98–1.64；p = 0.07），而在马里，中度消瘦的情况也是如此（RR 1.27；95% CI 0.98–1.64；p = 0.07）。然而，这些关联并未在严重受影响的儿童中观察到，而且各国之间也不一致。年龄 MUAC 与疟疾风险无关。尽管季节性疟疾化学预防和长效杀虫蚊帐的覆盖率很高，但营养不良和疟疾在研究地区都很常见。然而，没有发现强有力或一致的证据表明任何营养指标与随后的临床疟疾发病率之间存在关联。在线版本包含可在 10.1186/s12936-021-03802-2 获取的补充材料。
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. 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. 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. 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. The online version contains supplementary material available at 10.1186/s12936-021-03802-2.
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影响因子：
3.3
作者：
Müller, O;Garenne, M;Becher, H
通讯作者：
Becher, H
影响因子：
7.1
作者：
Genton, B;Al-Yaman, F;Alpers, MP
通讯作者：
Alpers, MP
影响因子：
3
作者：
Arinaitwe E;Gasasira A;Verret W;Homsy J;Wanzira H;Kakuru A;Sandison TG;Young S;Tappero JW;Kamya MR;Dorsey G
通讯作者：
Dorsey G
影响因子：
1.8
作者：
Jones KD;Berkley JA
通讯作者：
Berkley JA
影响因子：
2
作者：
Deen, JL;Walraven, GEL;von Seidlein, L
通讯作者：
von Seidlein, L