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Protein energy malnutrition and cerebral malaria in Nigerian children
P E Olumese1, O Sodeinde, O G Ademowo
1Department of Pharmacology & Therapeutics, College of Medicine, University of Ibadan, Nigeria.
Insights
Malnourished children (< 5 years) with cerebral malaria had better outcomes than well-nourished children. Malnutrition was less common in cerebral malaria cases compared to other pediatric patients. Nutritional rehabilitation should include malaria chemoprophylaxis.
Area of Science:
- Pediatrics
- Infectious Diseases
- Nutrition
Background:
- Cerebral malaria is a severe complication of Plasmodium falciparum infection.
- Malnutrition is a common comorbidity in pediatric patients in endemic areas.
- The relationship between malnutrition and cerebral malaria outcomes requires further investigation.
Purpose of the Study:
- To determine the prevalence of malnutrition among children with cerebral malaria.
- To compare outcomes between malnourished and well-nourished children with cerebral malaria.
- To inform clinical recommendations for managing malnourished children at risk of malaria.
Main Methods:
- Retrospective analysis of 57 pediatric cerebral malaria cases (< 5 years).
- Comparison of malnutrition prevalence with 319 other pediatric patients in the same ward.
- Assessment of clinical outcomes (mortality, neurological deficits) based on nutritional status.
Main Results:
- Malnutrition was present in 14% of cerebral malaria patients, significantly lower than other pediatric patients (35%).
- Poor outcomes were more frequent in malnourished cerebral malaria patients (4/8) compared to well-nourished ones (7/49).
- Specific malnutrition types included marasmus and kwashiorkor.
Conclusions:
- Malnutrition is less prevalent in pediatric cerebral malaria than anticipated.
- Malnourished children with cerebral malaria face a higher risk of adverse outcomes.
- Malaria chemoprophylaxis is recommended during nutritional rehabilitation for at-risk children.
Abstract:
Eight (14 per cent) out of 57 consecutive cerebral malaria patients (all < 5 years old) were malnourished, including one with marasmus and another recovering from kwashiorkor. This was significantly lower than among other paediatric patients in the same children's emergency ward (112/319, i.e. 35 per cent, P < 0.01). Poor outcomes (death or recovery with neurological deficits) were commoner in the malnourished group (4/8) than the well nourished group (7/49) (P = 0.037, Fisher's exact test). Malnourished children should receive malaria chemoprophylaxis during nutritional rehabilitation.