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Anti‐malarial drug resistance, malnutrition and socio‐economic status
Author(s) -
Hess F. I.,
Nukuro E.,
Judson L.,
Rodgers J.,
Nothdurft H. D.,
Rieckmann K. H.
Publication year - 1997
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1046/j.1365-3156.1997.d01-377.x
Subject(s) - malnutrition , malaria , medicine , logistic regression , incidence (geometry) , chloroquine , drug resistance , prospective cohort study , demography , pediatrics , immunology , biology , physics , microbiology and biotechnology , sociology , optics
To investigate the relationship between nutritional status and resistance to chloroquine treatment, we designed a nested case‐control study prospective with respect to the outcome of Plasmodium falciparum ‐infected school children aged 5–14 years from Honiara, Solomon Islands. 38 chloroquine‐resistant cases were compared with treatment‐susceptible controls with respect to current nutritional status, behavioural characteristics, medical and demographic data. The overall prevalence of moderate malnutrition was 28%. The incidence rate of chloroquine resistance was 23%. Malnourished children were generally at higher risk for treatment failure than well‐nourished ones (OR: 3.6; 95%CI: 1.6–8.4; P = 0.001). This effect was modified by socio‐economic status. Stratified analysis by logistic regression resulted in an eightfold risk of resistance for malnourished children in the higher socio‐economic category (OR:8.1; 95%CI: 2.4–27.9; P = 0.0001). In children from the lower socio‐economic group, the effect of malnutrition was not significant (OR:1.5; 95%CI:0.4–5.6). Socio‐economic differences may affect the immune status. The treatment response in children of lower socio‐economic status, which are more exposed to malaria, may therefore be less affected by malnutrition.