Interaction between Malnutrition and Severe Malaria among Children at the National Hospital of Niamey-Niger

Summary: Problem: Malnutrition and malaria are responsible for high mortality rate in Niger. The interaction between malnutrition and malaria remains controversial.

Methodology: We analyzed the retrospective data (2014 and 2015) of malarious children referred to the pediatric departments of Niamey National Hospital. Malnutrition was assessed by measuring MUAC and weight-height index. The criteria for the severity of malaria are those defined by the World Health Organization (WHO) in 2015. The present study aimed at assessing the relative risk between malnutrition and the severity of malaria.

Results: Nine point thirty-four percent (91/974) of patients were malnourished, of which 38.46% (35/91) were severely malnourished and 61.54% (56/91) were moderately malnourished. Seventy-nine point twelve percent (72/91) of the malnourished had severe malaria compared with 20.88% (19/91) who had uncomplicated malaria (Odds Ratio = 0.7, p = 0.3). There is a statistically significant difference in parasite density between the two malnourished groups (p=0.02). Fourteen point twenty eight percent (5/35) of the malnourished had died of malaria (Odds Ratio = 1.6, p = 0.2). Forty percent (2/5) of the severely malnourished died of malaria, compared to 60% (3/5) of the moderately malnourished (Odds Ratio = 0.9, p = 0.6). The leading causes of death among malnourished people were severe anemia (80%) and shock (20%).

Conclusion: Global acute malnutrition is a factor of severity of malaria. There is no statistically significant difference in risk of malaria death between moderate malnourished and severe malnourished.