RELATION OF ANTHROPOMETRY TO MALARIA MORBIDITY AND IMMUNITY IN PAPUA-NEW-GUINEAN CHILDREN

The interaction between malnutrition and malaria is complex and there is evidence that malnutrition decreases the susceptibility to malaria. To investigate the relation between anthropometric measurements and s ubsequent malaria morbidity and to examine whether the effect observed was due to interaction with host immunity, we followed for 1 y a coho rt of 136 children aged 10 to < 120 mo in Wosera, East Sepik Province, Papua New Guinea. At baseline, 21% were stunted, 10% were wasted, and 5% were both stunted and wasted. After adjustment for age and use of bed nets, height-for-age z score (HAZ) at baseline predicted the numbe r of clinical episodes of falciparum malaria during the following year : incidence rate increased with increasing HAZ. Humoral responses to s pecific malarial antigens were lowest in the wasted children. The prev alence of lymphoproliferative responders was not significantly differe nt between well-nourished and undernourished children. In contrast, th e prevalence of cytokine producers was higher in the undernourished th an in the well-nourished children. Our findings support the view that stunting but not wasting protects against falciparum malaria. The mech anism may be related to an improved ability of malnourished children t o produce certain cytokines in response to stimulation by specific mal arial antigens.