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Clinical Malaria and Nutritional Status in Children Admitted in Lwiro Hospital, Democratic Republic of Congo

Mitangala Ndeba Prudence, Umberto D’Alessandro, Philippe Donnen, Philippe Hennart, Denis Porignon, Bisimwa Balaluka Ghislain, Zozo Nyarukweba Déogratias and Michèle Dramaix Wilmet

Abstract
Background: The relationship between malaria and nutritional status is still unclear and difficult to establish.
Methods: For this purpose, information on 1 994 children admitted between January 2003 and November 2006
in Lwiro paediatric hospital, located in the Kivu region in the east of the Democratic Republic of Congo (RDC), was
analyzed. The relationship between indicators of Protein Energy Malnutrition (PEM) on admission and the risk of
clinical malaria during hospitalization was determined using Poisson regression.
Results: The clinical malaria incidence during hospitalization was 7.65/1 000 child-days (228/29 803) and was
significantly higher in children with the lowest nutritional indexes, requiring therapeutic feeding. Multivariate analysis
showed that malaria incidence was significantly higher in children with the middle upper arm circumference < 115
mm (IRR: 1.75; 95% CI: 1.16 – 2.38) and with nutritional oedemas (IRR 1.66; 95% CI: 1.16 – 2.38).
Conclusion: Children hospitalized with severe PEM and undergoing therapeutic refeeding were at a higher risk
of clinical malaria and should be specifically protected against such a risk.