Association between Malnutrition and Immunoglobulin G Responses to Crude Asexual P. falciparum schizont Lysates in Children Attending Ishiara Hospital, Embu County, Kenya

Abstract

Aim: The aim of this study was to determine levels of Plasmodium falciparum parasitaemia in children and relationship between IgG responses against the parasite and nutritional status of children. Study Design: Cross sectional study of children diagnosed positive for P. faciparum in Ishiara District Hospital, Embu county, Kenya was done between August 2011 and June 2012. Methodology: A total of 380 children, under 5 years who tested positive to P. faciparum infection were used for the study. Children with less than -2 Z score of height-for-age were classified as stunted and those with less than -2 Z score of weight-for-height were classified as wasted.  Malnourished children were identified by the criteria of WHO. P. faciparum parasitaemia was determined by microscopy, using Giemsa stained thin and thick blood smears while the parasite`s IgG antibody responses were assessed by the Enzyme linked immune-sorbent assay. Results: Of the 380 children 70% were malnourished. Of the malnourished children 30% were stunted, 37% wasted while 3% were both stunted and wasted. Well nourished children had mean parasitaemia of 530 per micro litre which was lower (P<0.05) than mean parasitaemia 590 per micro litre of the malnourished children. There was no correlation between parasitaemia and wasting(r=0.4, P>0,05). IgG responses of well nourished children (1.9) was higher than 1.2 of wasted children (r=0.7. P<0.05), this implies a negative correlation between wasting and IgG response. The same pattern of correlation was observed between well nourished children and the stunted (r = -0.6; P < 0.05) and also between the well-nourished and those both stunted and wasted (r = -0.8; P < 0.05). Conclusion: This study showed that malnutrition reduces IgG responses of children below 5 years to P. falciparum infection and predisposes them to malaria.