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The impact of malarial infection and diet on the anaemia status of rural pregnant Malawian women.
Eur J Clin Nutr. 1999 Oct; 53(10):792-801.EJ

Abstract

OBJECTIVE

To investigate haematological and biochemical iron indices in relation to malaria, gravida, and dietary iron status in rural pregnant Malawian women.

DESIGN

In this self-selected sample, haemoglobin, haematocrit, red cell indices, serum ferritin, serum iron, serum transferrin, and serum transferrin receptor (TfR) were measured. Infection was assessed by a malaria slide, serum C-reactive protein, and white blood cell count. Dietary iron variables were measured by three 24-h interactive recalls.

SETTING AND SUBJECTS

152 rural pregnant women recruited at 24 weeks gestation while attending a rural antenatal clinic in Southern Malawi; 36% were primagravid; 43% were gravida 2-4; 26% were gravida >5.

RESULTS

Of the women, 69% (n=105) were anaemic (haemoglobin <110 g/l); 37% (n=39) had anaemia and malarial parasitaemia on the test day; 17% (n=26) with malaria were also classified with iron deficiency (ID) anaemia (based on serum ferritin < or = 50 microg/l and Hb <110 g/l) while an additional seven with malaria were classified with ID without anaemia. In malarial-free subjects, 32% were classified with IDA (serum ferritin <12 microg/l and Hb <110 g/l) and 17% with ID (serum ferritin <12 microg/l; Hb > or = 110 g/l). Serum TfR concentrations were elevated in anaemic women (P<0.01). In non-malarial parasitaemic subjects, serum TfR correlated negatively with haemoglobin (r=-0.313; P<0.001) but not serum ferritin. Of the women, 49% were at risk for inadequate iron intakes. Most dietary iron was non-haem; plant foods provided 89%; flesh foods (mainly fish) only 9%. Malarial parasitaemia and intakes of available iron impacted significantly on iron status.

CONCLUSION

Anaemia prevalence from all causes was high (that is, 69%); three factors were implicated: malaria, and deficiencies of iron and possibly folate, induced partly by an inadequate dietary supply and/or secondary to malarial parasitaemia.

SPONSORSHIP

International Development Research Centre (IDRC) of Canada. Opportunities for Micronutrient Interventions (OMNI) Project. Natural Sciences and Engineering Research Council of Canada.

Authors+Show Affiliations

Division of Applied Human Nutrition, University of Guelph, Ontario, Canada.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10556986

Citation

Huddle, J M., et al. "The Impact of Malarial Infection and Diet On the Anaemia Status of Rural Pregnant Malawian Women." European Journal of Clinical Nutrition, vol. 53, no. 10, 1999, pp. 792-801.
Huddle JM, Gibson RS, Cullinan TR. The impact of malarial infection and diet on the anaemia status of rural pregnant Malawian women. Eur J Clin Nutr. 1999;53(10):792-801.
Huddle, J. M., Gibson, R. S., & Cullinan, T. R. (1999). The impact of malarial infection and diet on the anaemia status of rural pregnant Malawian women. European Journal of Clinical Nutrition, 53(10), 792-801.
Huddle JM, Gibson RS, Cullinan TR. The Impact of Malarial Infection and Diet On the Anaemia Status of Rural Pregnant Malawian Women. Eur J Clin Nutr. 1999;53(10):792-801. PubMed PMID: 10556986.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The impact of malarial infection and diet on the anaemia status of rural pregnant Malawian women. AU - Huddle,J M, AU - Gibson,R S, AU - Cullinan,T R, PY - 1999/11/11/pubmed PY - 1999/11/11/medline PY - 1999/11/11/entrez SP - 792 EP - 801 JF - European journal of clinical nutrition JO - Eur J Clin Nutr VL - 53 IS - 10 N2 - OBJECTIVE: To investigate haematological and biochemical iron indices in relation to malaria, gravida, and dietary iron status in rural pregnant Malawian women. DESIGN: In this self-selected sample, haemoglobin, haematocrit, red cell indices, serum ferritin, serum iron, serum transferrin, and serum transferrin receptor (TfR) were measured. Infection was assessed by a malaria slide, serum C-reactive protein, and white blood cell count. Dietary iron variables were measured by three 24-h interactive recalls. SETTING AND SUBJECTS: 152 rural pregnant women recruited at 24 weeks gestation while attending a rural antenatal clinic in Southern Malawi; 36% were primagravid; 43% were gravida 2-4; 26% were gravida >5. RESULTS: Of the women, 69% (n=105) were anaemic (haemoglobin <110 g/l); 37% (n=39) had anaemia and malarial parasitaemia on the test day; 17% (n=26) with malaria were also classified with iron deficiency (ID) anaemia (based on serum ferritin < or = 50 microg/l and Hb <110 g/l) while an additional seven with malaria were classified with ID without anaemia. In malarial-free subjects, 32% were classified with IDA (serum ferritin <12 microg/l and Hb <110 g/l) and 17% with ID (serum ferritin <12 microg/l; Hb > or = 110 g/l). Serum TfR concentrations were elevated in anaemic women (P<0.01). In non-malarial parasitaemic subjects, serum TfR correlated negatively with haemoglobin (r=-0.313; P<0.001) but not serum ferritin. Of the women, 49% were at risk for inadequate iron intakes. Most dietary iron was non-haem; plant foods provided 89%; flesh foods (mainly fish) only 9%. Malarial parasitaemia and intakes of available iron impacted significantly on iron status. CONCLUSION: Anaemia prevalence from all causes was high (that is, 69%); three factors were implicated: malaria, and deficiencies of iron and possibly folate, induced partly by an inadequate dietary supply and/or secondary to malarial parasitaemia. SPONSORSHIP: International Development Research Centre (IDRC) of Canada. Opportunities for Micronutrient Interventions (OMNI) Project. Natural Sciences and Engineering Research Council of Canada. SN - 0954-3007 UR - https://www.unboundmedicine.com/medline/citation/10556986/The_impact_of_malarial_infection_and_diet_on_the_anaemia_status_of_rural_pregnant_Malawian_women_ L2 - https://doi.org/10.1038/sj.ejcn.1600851 DB - PRIME DP - Unbound Medicine ER -