Malaria and Urinary Tract Infections among Children Under five Years with Malnutrition at a District Hospital in Ghana

Document Type : Original Research

Authors
E. Ameyaw 1
I. Okyere 1
T. Jibril Afaa 2
R. Ameyaw 3
T. O. Konney 1
P. Tuah 4
1 Kwame Nkrumah University of Science and Technology,Ghana
2 University of Ghana Medical School, Ghana
3 Nursing and Midwifery Training College, Ghana
4 Nutritional Rehabilitation Unit, Maternal and Child Health Hospital, Ghana
10.52547/iem.8.1.43
Abstract
Background: Malnutrition is a major cause of morbidity and mortality in children under five years. This study aimed to evaluate malaria and urinary tract infections among children under five years of age with malnutrition.

Materials & Methods: This cross-sectional study was carried out on 189 children under five years with malnutrition. Their weight and height were measured using standard scales. Weight to height/length (wasting), weight to age (underweight), and height/length to age (stunting) ratios were computed using WHO growth charts. Clinical features were assessed. Blood smear, rapid diagnostic test for malaria, as well as urine dipstick test were done to detect those with malaria and urinary tract infections.

Findings: About 80.95% of participants had marasmus, and 11.64% had marasmic kwashiorkor, while 7.41% had kwashiorkor. Also, 23.70 and 62.42% of participants had moderate and severe malnutrition, respectively; in addition, 21.69 and 2.12% were moderately and severely stunted, respectively. Regarding underweight (weight to age), 50.26 and 4.76% were moderately and severely underweight, respectively. Also, 15.87% of participants had a positive blood smear for malaria, and 19.58% had a positive rapid diagnostic test for malaria, while 20.11 and 20.63% had positive results for nitrite and leukocyte esterase activity in urine dipstick test, respectively.

Conclusion: Malaria and urinary tract infections are common among children with malnutrition and could be diagnosed using simple laboratory tests such as rapid diagnostic tests and urine dipstick tests in health facilities without laboratory support in resource-limited countries.

Keywords

Subjects

1. Nikoi E and Anthamatten P. An examination of environmental correlates with childhood height-for-age in Ghana. Public health nutrition. 2013;16:46-53.
2. Bain LE, Awah PK, Geraldine N, Kindong NP, Siga Y, Bernard N and Tanjeko AT. Malnutrition in Sub–Saharan Africa: burden, causes and prospects. Pan African Medical Journal. 2013;15:1-9.
3. Katona P, Katona-Apte J. The Interaction between Nutrition and Infection. Clinical Infectious Disease. 2008;46:1582-1588.
4. Martorell R. Improved Nutrition in the First 1000 Days and Adult Human Capital and Health. American Journal of Human Biology. 2017;29(2):1-12.
5. França TGD, Ishikawa LLW, Zorzella-Pezavento SFG, Chiuso-Minicucci F, da Cunha MLRS, Sartori A. Impact of malnutrition on immunity and infection. J Venom Anim Toxins incl Trop Dis. 15(3):374-390.
6. Black RE, Allen LH, Bhutta ZA, Caulfield LE, de Onis M, Ezzati M, Mathers C. Maternal and Child Undernutrition Study Group. Maternal and child undernutrition: Global and regional exposures and health consequences. Lancet. 2008;371:243-60.
7. Uwaezuoke NS. The prevalence of urinary tract infection in children with severe acute malnutrition: a narrative review. Pediatric Health Medicine and Therapeutics. 2016;7:121-127.
8. Oldenburg CE, Guerin PJ, Berthé F, Grais RF and Isanaka S. Malaria and Nutritional Status Among Children With Severe Acute Malnutrition in Niger: A Prospective Cohort Study. Clinical Infectious Diseases. 2018;67(7):1027-1034.
9. Shikur B, Deressa W and Lindtjørn B. Association between malaria and malnutrition among children aged under-five years in Adami Tulu District, south-central Ethiopia: a case–control study. BMC Public Health. 2016;16:174-182.
10. Fevang P, Havemann K, Fevang B and Høstmark AT. Malaria and Malnutrition: Kwashiorkor Associated with Low Levels of Parasitaemia. Malaria Research and Treatment. 2018;2018:1-5.
11. Ghana Malaria Indicator Survey 2019- Final Report. At https://dhsprogram.com/pubs/pdf/MIS35/MIS35.pdf. Accessed 19 November, 2021.
12. Rosli AW, Rauf S, Lisal JS, Albar H, Daud D. Relationship between protein energy malnutrition and urinary tract infection in children. Paediatrica Indonesiana. 2008;48(3):166-169.
13. Uwaezuoke SN, Ndu IK and Eze IC. The prevalence and risk of urinary tract infection in malnourished children: a systematic review and meta-analysis. BMC Pediatrics. 2019;19:261-271.
14. WHO child growth standards and the identification of severe acute malnutrition in infants and children. At https://www.google.com/search?client=firefox-b-d&q=WHO++child+growth+standards+and+the+identi%EF%AC%81cation+of+severe+acute+malnutrition+in+infants+and+children. Accessed 15 February, 2021
15. Farthing MJG and Ballinger AB. Anorexia and Cytokines in the Acute Phase Response to Infection. Nutrition, Immunity, and Infection in Infants and Children. 2001;45:303-317.
16. Umma AI, Wammanda DR, Jamilu AF, Garba DG. Prevalence of Bacteremia among Febrile Children with Severe Malnutrition in North Western Nigeria. Niger J Gen Pract. 2018;16:25-9.
Infection Epidemiology and Microbiology
Volume 8, Issue 1
February 2022
Pages 43-51