Undernutrition and malaria in African children

Reference Number: 
Dr Sarah Atkinson and John Muriuki



Malnutrition and malaria are major public health problems and tend to co-exist in African children. However, their relationship is complex and largely remains unclear. Previous studies have reported conflicting findings on whether malnutrition influences malaria risk. Some have reported a lack of association1–5, others increased risk6,7 while another reported a lower risk of malaria infection8. Furthermore, the mechanism through which nutritional status influences malaria infection remains unclear.

To determine whether malnutrition influences malaria infection, this study will use data from Kenyan and Ugandan longitudinal studies. In these studies, children were actively followed-up for malaria episodes. Nutritional and malaria-specific antibody data are available at baseline.


Question to be addressed by interns

1. What is the effect of malnutrition on malaria risk? The student will use Poisson regression models and survival analysis to answer this question. The student will also conduct a meta-analysis of all studies that have longitudinally investigated the effect of malnutrition on malaria risk (including the current study).

2. Does malnutrition influence natural immunity to malaria? The student will look at the effect of malnutrition on antibodies to malaria infection such as MSP1 and AMA1.


Skills to be acquired by intern

  • Literature review and the formulation of research questions and methodology
  • Data analyses – use of STATA and R packages for regression models and survival analysis
  • Writing of manuscripts


Preferred training background of required intern

  • Training in statistics and the use of statistical packages STATA and R is highly desirable.
  • Training in biomedical sciences, infectious disease and nutrition.



1.        Genton B, Al-Yaman F, Ginny M, Taraika J, Alpers MP. Relation of anthropometry to malaria morbidity and immunity in Papua New Guinean children. Am J Clin Nutr. 1998;68:734–41.

2.        Muller O, Garenne M, Kouyate B, Becher H. The association between protein – energy malnutrition , malaria morbidity and all-cause mortality in West African children. Trop Med Int Heal. 2003;8:507–11.

3.        Nyakeriga AM, Troye-blomberg M, Chemtai AK, Marsh K, Williams TN. Malaria and nutritional status in children living on the coast of. Am J Clin Nutr. 2004;190:439–47.

4.        Mitangala PN, D’Alessandro U, Donnen P, et al. Malaria infection and nutritional status: Results from a cohort survey of children from 6-59 months old in the Kivu province, Democratic Republic of the Congo. Rev D Epidemiol Sante Publique. 2013;61:111–20.

5.        Gari T, Loha E, Deressa W, Solomon T, Lindtjørn B. Malaria increased the risk of stunting and wasting among young children in Ethiopia: Results of a cohort study. PLoS One. 2018;13:1–16.

6.        Deen JL, Walraven GEL, von Seidlein L. Increased risk for malaria in chronically malnourished children under 5 years of  age in rural Gambia. J Trop Pediatr. 2002;48:78–83.

7.        Arinaitwe E, Gasasira A, Verret W, et al. The association between malnutrition and the incidence of malaria among young HIV-infected and -uninfected Ugandan children: A prospective study. Malar J. 2012;11:1–9.

8.        Fillol F, Cournil A, Boulanger D, et al. Influence of wasting and stunting at the onset of the rainy season on subsequent malaria morbidity among rural preschool children in Senegal. Am J Trop Med Hyg. 2009;80:202–8.


Application deadline: 11 February 2019