Skip to main content

Table 2 Relationship between chronic malnutrition (stunting) and risk of malarial infection (N = 23)

From: Complex interactions between malaria and malnutrition: a systematic literature review

Author, Year, Reference

HAZ cutoff

Malaria outcome

Risk estimate comparing children below and above HAZ cutoff

Risk

Akiyama 2016 [46]

≤ − 2

Asymptomatic malaria confirmed by PCR

OR = 3.34 (95% CI = 1.25–8.93)

Increased

Alexandre 2015 [47]

< − 2

Fever and thick blood smear

HR = 0.31 (95% CI = 0.10–0.99), P = 0.049

Decreased

Arinaitwe 2012 [48]

− 1 and −2

Pf malaria, fever and a positive blood smear

IRR = 1.24 (95% CI 1.06–1.46), P = 0.008

Increased

< − 2

Pf malaria, fever and a positive blood smear

IRR = 1.24 (95% CI 1.03–1.48), P = 0.02

Increased

Ayana 2015 [49]

< − 2

Malaria by RDT

HR = 2.50 (95% CI = 1.4–5.1)

Increased

Crookston 2010 [50]

≥ − 2 and < − 1

Asymptomatic malaria confirmed by PCR

OR = 2.23 (95% CI = 0.99–5.02)

No impact

≥ − 3 and < − 2

Asymptomatic malaria confirmed by PCR

OR = 0.56 (95% CI = 0.16–1.69)

No impact

< − 3

Asymptomatic malaria confirmed by PCR

OR = 1.02 (95% CI = 0.20–3.76)

No impact

Custodio 2009 [30]

< − 2

Pf malaria parasitemia prevalence

OR = 3.07 (95% CI = 1.40–6.73)

Increased

Deen 2002 [10]

< − 2

Malaria episode (fever ≥37.5 °C or parasitemia > 5000/μL)

RR = 1.35 (95% CI = 1.08–1.69), P = 0.01

Increased

Deribew 2010 [51]

< − 2

Pf malaria (any parasitemia)

AOR = 0.9 (95% CI = 0.7–1.2), P = 0.85

No impact

Fillol 2009 [27]

< − 2

Clinical malaria (fever ≥37.5 °C plus parasitemia ≥ 3000/μL)

“Non-significant association” reported

No impact

< − 2

High density parasitemia (geometric mean ≥ 300/μL)

AOR = 2.42 (95% CI = 1.12–5.24), P = 0.03

Increased

Friedman 2005 [26]

< − 2

Concurrent malaria (any parasitemia)

AOR = 1.98, P < 0.0001

Increased

< − 2

High density parasitemia (any species, > 1500–7000/μL)

AOR = 1.84, P < 0.0001

Increased

< − 2

Clinical malaria (fever plus high density parasitemia)

AOR = 1.77, P = 0.06

Increased

< −2

Severe anaemia (Haemoglobin < 7 g/dL)

AOR = 2.65, P < 0.0001*

Genton 1998 [14]

< − 2

Pf malaria (fever plus any parasitemia)

Adj. Rate ratio = 1.13 (95% CI = 0.98–1.29), P = 0.09

No impact

< −2

Pf malaria (fever plus parasitemia ≥ 5 × 109/L)

Adj. Rate ratio = 1.19 (95% CI = 1.01–1.40), P = 0.03

Increased

< −2

Pf malaria (fever plus parasitemia ≥ 10 × 109/L)

Adj. Rate ratio = 1.18 (95% CI = 0.98–1.41), P = 0.08

No impact

Kateera 2015 [54]

< − 2

Pf malaria (any parasitemia)

“Non-significant association” reported

No impact

Maketa 2015 [55]

≤ − 2

Asymptomatic malaria by blood smear

AOR = 1.8, P = 0.01

Increased

Mamiro 2005 [56]

< − 2

Malaria by blood smear

AOR = 1.9 (95% CI = 1.1–3.2), P = 0.02

Increased

Mitangala 2013 [21]

< − 2

Pf malaria parasitemia (≥ 5000/μL)

AOR = 0.72 (95% CI = 0.37–1.40)

No impact

< −3

Pf malaria parasitemia (≥ 5000/μL)

AOR = 0.48 (95% CI = 0.25–0.91)

Decreased

Muller 2003 [18]

≤ − 2

Pf malaria (fever plus parasitemia ≥ 1/μL)

RR = 1.0 (95% CI = 0.9–1.1), P = 0.87

No impact

≤ − 2

Pf malaria (fever plus parasitemia ≥ 5000/μL)

RR = 1.0 (95% CI = 0.9–1.2), P = 0.59

No impact

≤ − 2

Pf malaria (fever plus parasitemia ≥ 100,000/μL)

RR = 0.8 (95% CI = 0.5–1.4), P = 0.44

No impact

Nyakeriga 2004 [6]

< − 2

Pf malaria (fever plus any parasitemia)

Adj. IRR = 1.89 (95% CI = 1.01–3.53), P = 0.05

Increased

< − 2

Pf malaria (fever plus any para < 1 year, > 2500/μL > 1 year)

Adj. IRR = 1.93 (95% CI = 0.9–4.16), P = 0.09

Increased

Snow 1991 [17]

< − 2

Clinical malaria (fever plus any parasitemia)

“Non-significant association” reported

No impact

< −2

Asymptomatic malaria parasitemia

“Non-significant association” reported

No impact

Sumbele 2015 [57]

< − 2

Clinical malaria parasitemia

Stunted vs. Non-stunted: 16.9% vs. 7.5%, P = 0.01

Increased

< −2

Asymptomatic malaria parasitemia

Stunted vs. Non-stunted: 26.0% vs. 26.2%, P = 0.91

No impact

Tonglet 1999 [32]

< − 2

Clinical malaria without lab confirmation in < 9 m

AOR = 1.16 (95% CI = 0.54–1.77)

Increased

< −2

Clinical malaria without lab confirmation in ≥ 9 m

AOR = 0.71 (95% CI = 0.28–1.14)

No impact

Uscategui Penuela 2009 [58]

< − 2

Malaria infection

OR = 1.94 (95% CI = 1.07–3.50), P = 0.023

Increased

Verhoef 2002 [13]

< −2

Laboratory confirmed malaria

OR = 0.87 (95% CI = 0.69–1.09), P = 0.23

No impact

Verret 2011 [22]

≥ − 1 and < 0

Pf malaria risk of recurrent parasitemia

HR = 2.35 (95% CI = 0.85–6.48), P = 0.099

No impact

≥ −2 and < − 1

Pf malaria risk of recurrent parasitemia

HR = 2.89 (95% CI = 1.06–7.89), P = 0.039

Increased

< − 2

Pf malaria risk of recurrent parasitemia

HR = 3.18 (95% CI = 1.18–8.56), P = 0.022

Increased

  1. Pf Plasmodium falciparum, HAZ height-for-age Z-scores, CI confidence interval, OR odds ratio, HR hazard ratio, RR risk ratio, IRR incidence rate ratio, AOR adjusted odds ratio
  2. *Limited to anaemia