Abstract:
Protein-energy malnutrition is a serious clinical condition with high prevalence in
areas where Plasmodium falciparum is highly endemic such as western Kenya. There
is a major need to determine the relationship between PEM and malaria antibody
profiles especially in an area where malaria is endemic. The objective of this work,
therefore, was to determine the association between PEM and specific malaria
antibodies and the potential diagnostic value of the antibodies in children aged
between 5 and 59 months. Cross- sectional surveys as well as analysis of sera for
specific malaria antibodies were carried out at Asembo Division, Bondo District,
Kisumu County, Nyanza Province. A total of sixty villages identified through random
sampling with each household as the sampling unit were used for data collection. Two
thousand, one hundred and twelve (2112) Children < 5 years of age were sampled in
three successive cross- sectional surveys: The first survey included children < 3 years
of age while the subsequent two surveys included children < 5 years of age.
Anthropometric measurements were carried out followed by finger prick blood
sample for assay of antibodies in sera of the study children. Statistical variables (Odds
Ratio, at 95% CI) were determined using SPSS 11 and SAS computer packages. Both
Multivariate and Bivariate analyses were carried out. Epi-info 2002 package was used
to determine anthropometric variables. Demographic variables and malaria parasite
counts were determined for all the children sampled. Circumsporozoite Surface
Protein (CSP) IgG antibody was found to be significantly associated with stunting and
underweight (p<0.05) but not with wasting. Liver Stage Antigen (LSA) IgG antibody
was significantly associated with wasting only (p<0.05) while Merozoite Surface
Protein (MSP) IgG antibody was not significantly associated with any malnutrition
state. The mean concentration of CSP IgG was elevated in stunted, wasted and
underweight in comparison to controls. Liverstage antigen 1 IgG was elevated in
stunted children only as compared to controls, whereas MSP IgG was low in all PEM
cases as compared to controls. Specific Plasmodium falciparum antibody profiles
could accurately be used to determine the association between malaria and Protein Energy Malnut
