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Divergent results were reported on the effect of malnutrition on malaria risk. While no consistent association between risk of malaria and acute malnutrition was found, chronic malnutrition was relatively consistently associated with severity of malaria such as high-density parasitemia and anaemia.
Some studies have reported that children with previous exposure to malaria have a higher risk of becoming malnourished, as characterised by either stunting, underweight or wasting. Other studies have reported a lower risk, and others have reported no association between malaria and malnourishment at all [9, 10].
A MUAC of < 115 mm indicates SAM and significant mortality risk. – Weight for height (W/H) index assesses the degree of weight loss by comparing the weight of the SAM child with non-malnourished children of the same height.
Severe acute malnutrition (SAM) is associated with increased severity of common infectious diseases, and death amongst children with SAM is almost always as a result of infection. The diagnosis and management of infection are often different in malnourished versus well-nourished children.
Malaria is usually associated with mild anaemia, although where resources are limited, then even at these low transmission intensities P. vivax may still cause severe anaemia in children because each sporozoite inoculation can result in multiple relapses.
Since serum protein gets depleted by HIV infection and more depleted by malaria-HIV infection, there will be lower levels of albumin available for transport of bilirubin; consequently there will be a high amount of accumulated bilirubin that is untransported.
MAM is defined as MUAC < 12.5 cm, but ≥ 11.5 cm. Non-complicated SAM will be defined as MUAC < 11.5 cm, or + or ++ bilateral edema, and having an acceptable appetite. An acceptable appetite will be judged by giving the child 30 g of RUTF and asking the mother to feed this food to the child over 20 minutes.
There are 4 broad sub-forms of undernutrition: wasting, stunting, underweight, and deficiencies in vitamins and minerals.
Severe Acute Malnutrition (SAM) Severe acute malnutrition is defined by very low weight-for-height/length (Z- score below -3 SD of the median WHO child growth standards), or a mid-upper arm circumference < 115 mm, or by the presence of nutritional oedema.
Absence of acute protein-energy malnutrition, or normal nutritional status, is defined as having a weight-for-height z-score of -2.0 or greater. Moderate acute protein-energy malnutrition is defined as having a weight-for-height z-score of -3.0 to less than -2.0.
Malnutrition is often split into two broad groups of conditions:undernutrition, including stunting, wasting, underweight and micronutrient deficiencies.overweight, obesity and diet-related non-communicable diseases (NCDs).
Severe acute malnutrition is defined in these guidelines as the presence of oedema of both feet or severe wasting (weight-for-height/length <-3SD or mid-upper arm circumference < 115 mm).