The impact of malarial infection and diet on the anaemia status of rural pregnant Malawian women

Citation
Jm. Huddle et al., The impact of malarial infection and diet on the anaemia status of rural pregnant Malawian women, EUR J CL N, 53(10), 1999, pp. 792-801
Citations number
48
Categorie Soggetti
Endocrynology, Metabolism & Nutrition
Journal title
EUROPEAN JOURNAL OF CLINICAL NUTRITION
ISSN journal
09543007 → ACNP
Volume
53
Issue
10
Year of publication
1999
Pages
792 - 801
Database
ISI
SICI code
0954-3007(199910)53:10<792:TIOMIA>2.0.ZU;2-L
Abstract
Objective: To investigate haematological and biochemical iron indices in re lation to malaria, gravida, and dietary iron status in rural pregnant Malaw ian women. Design: In this self-selected sample, haemoglobin, haematocrit, red cell in dices, serum ferritin, serum iron, serum transferrin, and serum transferrin receptor (TfR) were measured. Infection was assessed by a malaria slide, s erum C-reactive protein, and white blood cell count. Dietary iron variables were measured by three 24-h interactive recalls. Setting and subjects: 152 rural pregnant women recruited at 24 weeks gestat ion while attending a rural antenatal clinic in Southern Malawi; 36% were p rimagravid; 43% were gravida 2-4; 26% were gravida > 5. Results: Of the women, 69% (n = 105) were anaemic (haemoglobin < 110 g/l); 37% (n = 39) had anaemia and malarial parasitaemia on the test day; 17% (n = 26) with malaria were also classified with iron deficiency (ID) anaemia ( based on serum ferritin less than or equal to 50 mu g/l and Hb < 110 g/l) w hile an additional seven with malaria were classified with ID without anaem ia. In malarial-free subjects, 32% were classified with IDA (serum ferritin < 12 mu g/l and Hb < 110 g/l) and 17% with ID (serum ferritin < 12 mu g/l; Hb greater than or equal to 110 g/l). Serum TW concentrations were elevate d in anaemic women (P < 0.01). In non-malarial parasitaemic subjects, serum TW correlated negatively with haemoglobin (r = -0.313; P < 0.001) but not serum ferritin. Of the women, 49% were at risk for inadequate iron intakes. Most dietary iron was non-haem; plant foods provided 89%; flesh foods (mai nly fish) only 9%. Malarial parasitaemia and intakes of available iron impa cted significantly on iron status. Conclusion: Anaemia prevalence from all causes was high (that is, 69%); thr ee factors were implicated: malaria, and deficiencies of iron and possibly folate, induced partly by an inadequate dietary supply and/or secondary to malarial parasitaemia. Sponsorship: International Development Research Centre (IDRC) of Canada. Op portunities for Micronutrient Interventions (OMNI) Project. Natural Science s and Engineering Research Council of Canada.