Influence of nutritional status on pro and anti inflammatory cytokine balance in Plasmodium falciparum malaria children in Imo State, Nigeria

Background: In malaria endemic regions, malnutrition has also been reported to be a public health problem and an important factor modulating the risk of malaria. Proinflammatory cytokines are known mediators of malnutrition with higher risk in sub Saharan African Countries. Given the fact that the pattern of the host innate immunity mediated by proinflammatory cytokines and the balance between the pro and anti inflammatory cytokines is critical in determining malaria outcomes. Understanding the impact of malnutrition on pro and antiinflammatory cytokine response in Plasmodium falciparum (p.f) infected children is very important for malaria control. No Studies in Nigeria has examined the relationship between nutritional status, pro and anti inflammatory cytokine ratio and malaria. We specifically examined the balance between Interleukin 10, Tumour Necrosis Factor (TNF) and nutritional status of plasmodium falciparum malaria children in South Eastern Nigeria. This study determined nutritional status and evaluated the influence of malnutrition on immune response. Methods & Materials: 1344 children aged 1-72 Months with ongoing fever or history of fever within the last 24 hours and with no sign suggestive of severe malaria were microscopically screened for P.f in a cross sectional descriptive study at Ogwa General hospital and Federal Medical Center Owerri, Imo State Nigeria. Their Nutritional status was determined using the international Reference Population defined by the U.S National Center for Health Statistics (NCHS). Blood films were stained with Geimsa stain and malaria identified microscopically. IL-10 and TNF were assayed by ELISA. Statistical analysis was done using SPSS version 17. Study protocol was approved by FMC Owerri ethical committee. Results: Non significant proportions were stunted (22.9%), Under weight (9.4%) and wasted (5.2%). These findings show no significant relationship between presence of malaria and stunting, a measure of chronic under nutrition. Underweight and wasting had no significant relationship with Malaria rather stunting and wasting were associated with age (p< 0.05). IL-10/TNF ratio was significantly associated with parasite density and age (p<0.05). IL10/TNF ratio was lower in children 1-24 months when compared with older children. Conclusion: This study suggests no association between malnutrition and malaria.