PLASMODIUM-VIVAX - A CAUSE OF MALNUTRITION IN YOUNG-CHILDREN

We studied the aetiology of malnutrition in a cohort of 1511 children <10 years old in Espiritu Santo, Vanuatu. Malnutrition was categorized using standard anthropometric criteria as: underweight [weight-for-ag e (WA) Z score <-2], wasting [weight-for-height (WH) Z <-2], or stunti ng [height-for-age (HA) Z <-2]. On multiple logistic regression analys is, the only factors significantly associated with wasting were age <5 years [OR (95% CI) 1.8 (1.2-2.9), p=0.01] and having suffered one or more episodes of clinical P. vivax malaria in the 6 months preceding n utritional assessment EOR 2.4 (1.3-4.4), p=0.006]. The incidence of P. vivax infection was significantly higher during the 6 months precedin g assessment in underweight vs. non-underweight children [incidence ra te ratio (IRR) 2.6 (1.5-4.4), p less than or equal to 0.0001). These g roups had similar incidences of clinical P. falciparum infection durin g the same period [IRR 1.1 (0.57-2.1) p=0.8] and of either species dur ing the 6 months following assessment [IRR P. vivax 1.3 (0.9-2.0) p=0. 2; IRR P. falciparum 1.3 (0.9-1.9) p=0.2]. In these children, P. vivax malaria was a major predictor of acute malnutrition; P. falciparum wa s not. Wasting neither predisposed to nor protected against malaria of either species. Although P. vivax malaria is generally regarded as be nign, it may produce considerable global mortality through malnutritio n.