Associations between undernutrition and malaria infection: a case-control study from Rwanda
Aline Uwimana1,2,3, Hélène Alexiou4, Jean d'Amour Mutoni1,5
1Metabolism and Nutrition Research Group, Louvain Drug Research Institute (LDRI), UCLouvain, Université Catholique de Louvain, Brussels, Belgium.
Malaria Journal
|October 15, 2025
Summary
Nutrient deficiencies, particularly vitamin E and iron, are linked to increased malaria risk. Improving dietary diversity and monitoring nutrition are key to prevention strategies for these global health challenges.
Area of Science:
- Nutrition Science
- Infectious Disease Epidemiology
- Public Health
Background:
- Undernutrition and malaria are significant global health issues with complex interdependencies.
- Understanding the link between nutritional status and malaria is crucial for effective prevention and control.
- Undernutrition indicators include nutrient intake and stunting (child too short for age).
Purpose of the Study:
- To investigate the association between inadequate nutrient intake or indicators of undernutrition and malaria infection.
- To analyze the relationship between specific micronutrient deficiencies and malaria risk.
- To explore the role of stunting as an indicator of undernutrition in relation to malaria.
Main Methods:
- A case-control study comparing malaria cases (positive blood smear) with malaria-free household controls.
- Data collected from November 2021 to December 2023 across 9 endemic districts.
- Regression models used to assess associations between undernutrition indicators (nutrient intake, stunting) and malaria infection.
Main Results:
- Dietary patterns were imbalanced, with starchy staples dominating energy intake (56.7%).
- High risk of deficiencies in Vitamin A, B2, B12, calcium, zinc, and selenium (50-80%).
- Vitamin E and iron deficiencies were positively associated with malaria risk (aOR=7.46, aOR=1.80). Increasing age, female sex, and selenium deficiency were inversely associated with malaria.
Conclusions:
- Nutrient imbalances play a critical role in influencing malaria infections.
- Targeted strategies, including improving dietary diversity and monitoring nutritional status, are essential.
- Developing a national food composition database can support effective nutrition policies and interventions.
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