Skip to main content

Table 2 Relationship between chronic malnutrition (stunting) and risk of malarial infection (N = 23)

From: Complex interactions between malaria and malnutrition: a systematic literature review

Author, Year, Reference HAZ cutoff Malaria outcome Risk estimate comparing children below and above HAZ cutoff Risk
Akiyama 2016 [46] ≤ − 2 Asymptomatic malaria confirmed by PCR OR = 3.34 (95% CI = 1.25–8.93) Increased
Alexandre 2015 [47] < − 2 Fever and thick blood smear HR = 0.31 (95% CI = 0.10–0.99), P = 0.049 Decreased
Arinaitwe 2012 [48] − 1 and −2 Pf malaria, fever and a positive blood smear IRR = 1.24 (95% CI 1.06–1.46), P = 0.008 Increased
< − 2 Pf malaria, fever and a positive blood smear IRR = 1.24 (95% CI 1.03–1.48), P = 0.02 Increased
Ayana 2015 [49] < − 2 Malaria by RDT HR = 2.50 (95% CI = 1.4–5.1) Increased
Crookston 2010 [50] ≥ − 2 and < − 1 Asymptomatic malaria confirmed by PCR OR = 2.23 (95% CI = 0.99–5.02) No impact
≥ − 3 and < − 2 Asymptomatic malaria confirmed by PCR OR = 0.56 (95% CI = 0.16–1.69) No impact
< − 3 Asymptomatic malaria confirmed by PCR OR = 1.02 (95% CI = 0.20–3.76) No impact
Custodio 2009 [30] < − 2 Pf malaria parasitemia prevalence OR = 3.07 (95% CI = 1.40–6.73) Increased
Deen 2002 [10] < − 2 Malaria episode (fever ≥37.5 °C or parasitemia > 5000/μL) RR = 1.35 (95% CI = 1.08–1.69), P = 0.01 Increased
Deribew 2010 [51] < − 2 Pf malaria (any parasitemia) AOR = 0.9 (95% CI = 0.7–1.2), P = 0.85 No impact
Fillol 2009 [27] < − 2 Clinical malaria (fever ≥37.5 °C plus parasitemia ≥ 3000/μL) “Non-significant association” reported No impact
< − 2 High density parasitemia (geometric mean ≥ 300/μL) AOR = 2.42 (95% CI = 1.12–5.24), P = 0.03 Increased
Friedman 2005 [26] < − 2 Concurrent malaria (any parasitemia) AOR = 1.98, P < 0.0001 Increased
< − 2 High density parasitemia (any species, > 1500–7000/μL) AOR = 1.84, P < 0.0001 Increased
< − 2 Clinical malaria (fever plus high density parasitemia) AOR = 1.77, P = 0.06 Increased
< −2 Severe anaemia (Haemoglobin < 7 g/dL) AOR = 2.65, P < 0.0001*
Genton 1998 [14] < − 2 Pf malaria (fever plus any parasitemia) Adj. Rate ratio = 1.13 (95% CI = 0.98–1.29), P = 0.09 No impact
< −2 Pf malaria (fever plus parasitemia ≥ 5 × 109/L) Adj. Rate ratio = 1.19 (95% CI = 1.01–1.40), P = 0.03 Increased
< −2 Pf malaria (fever plus parasitemia ≥ 10 × 109/L) Adj. Rate ratio = 1.18 (95% CI = 0.98–1.41), P = 0.08 No impact
Kateera 2015 [54] < − 2 Pf malaria (any parasitemia) “Non-significant association” reported No impact
Maketa 2015 [55] ≤ − 2 Asymptomatic malaria by blood smear AOR = 1.8, P = 0.01 Increased
Mamiro 2005 [56] < − 2 Malaria by blood smear AOR = 1.9 (95% CI = 1.1–3.2), P = 0.02 Increased
Mitangala 2013 [21] < − 2 Pf malaria parasitemia (≥ 5000/μL) AOR = 0.72 (95% CI = 0.37–1.40) No impact
< −3 Pf malaria parasitemia (≥ 5000/μL) AOR = 0.48 (95% CI = 0.25–0.91) Decreased
Muller 2003 [18] ≤ − 2 Pf malaria (fever plus parasitemia ≥ 1/μL) RR = 1.0 (95% CI = 0.9–1.1), P = 0.87 No impact
≤ − 2 Pf malaria (fever plus parasitemia ≥ 5000/μL) RR = 1.0 (95% CI = 0.9–1.2), P = 0.59 No impact
≤ − 2 Pf malaria (fever plus parasitemia ≥ 100,000/μL) RR = 0.8 (95% CI = 0.5–1.4), P = 0.44 No impact
Nyakeriga 2004 [6] < − 2 Pf malaria (fever plus any parasitemia) Adj. IRR = 1.89 (95% CI = 1.01–3.53), P = 0.05 Increased
< − 2 Pf malaria (fever plus any para < 1 year, > 2500/μL > 1 year) Adj. IRR = 1.93 (95% CI = 0.9–4.16), P = 0.09 Increased
Snow 1991 [17] < − 2 Clinical malaria (fever plus any parasitemia) “Non-significant association” reported No impact
< −2 Asymptomatic malaria parasitemia “Non-significant association” reported No impact
Sumbele 2015 [57] < − 2 Clinical malaria parasitemia Stunted vs. Non-stunted: 16.9% vs. 7.5%, P = 0.01 Increased
< −2 Asymptomatic malaria parasitemia Stunted vs. Non-stunted: 26.0% vs. 26.2%, P = 0.91 No impact
Tonglet 1999 [32] < − 2 Clinical malaria without lab confirmation in < 9 m AOR = 1.16 (95% CI = 0.54–1.77) Increased
< −2 Clinical malaria without lab confirmation in ≥ 9 m AOR = 0.71 (95% CI = 0.28–1.14) No impact
Uscategui Penuela 2009 [58] < − 2 Malaria infection OR = 1.94 (95% CI = 1.07–3.50), P = 0.023 Increased
Verhoef 2002 [13] < −2 Laboratory confirmed malaria OR = 0.87 (95% CI = 0.69–1.09), P = 0.23 No impact
Verret 2011 [22] ≥ − 1 and < 0 Pf malaria risk of recurrent parasitemia HR = 2.35 (95% CI = 0.85–6.48), P = 0.099 No impact
≥ −2 and < − 1 Pf malaria risk of recurrent parasitemia HR = 2.89 (95% CI = 1.06–7.89), P = 0.039 Increased
< − 2 Pf malaria risk of recurrent parasitemia HR = 3.18 (95% CI = 1.18–8.56), P = 0.022 Increased
  1. Pf Plasmodium falciparum, HAZ height-for-age Z-scores, CI confidence interval, OR odds ratio, HR hazard ratio, RR risk ratio, IRR incidence rate ratio, AOR adjusted odds ratio
  2. *Limited to anaemia