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Revista do Instituto de Medicina Tropical de São Paulo

On-line version ISSN 1678-9946

Rev. Inst. Med. trop. S. Paulo vol.37 no.1 São Paulo Jan./Feb. 1995

http://dx.doi.org/10.1590/S0036-46651995000100004 

PARASITOLOGY

 

The malarial impact on the nutritional status of Amazonian adult subjects

 

Impacto da malaria no estado nutricional de doentes adultos da Amazônia

 

 

Paulo C. M. Pereira; Domingos A. Meira; Paulo R. Curi; Nelson de Souza; Roberto C. Burini

Nutritional Biochemistry Laboratory and Tropical Medicine Departament, UNESP Medical School, Botucatu, SP, Brasil

Correspondence to

 

 


SUMMARY

The anthropometric (body weight, height, upper arm circumference, triceps and subescapular skinfolds; Quetelet index and arm muscle circunference) and blood biochemistry (proteins and lipids) parameters were evaluated in 93 males and 27 females, 17-72 years old voluntaries living in the malarial endemic area of Humaita city (southwest Amazon). According to their malarial history they were assembled in four different groups: G1-controls without malarial history (n:30); G2 - controls with malarial history but without actual manifestation of the disease (n:40); G3 - patients with Plasmodium vivax (n:19) and G4 - patients with Plasmodium falciparum (n:31). The malarial status was stablished by clinical and laboratory findings. The overall data of anthropometry and blood biochemistry discriminated the groups differently. The anthropometric data were low sensitive and contrasted only the two extremes (G1>G4) whereas the biochemistry differentiated two big groups, the healthy (G1+G2) and the patients (G3+G4). The nutritional status of the P. falciparum patients was highly depressed for most of the studied indices but none was sensitive enough to differentiate this group from the P. vivax group (G3). On the other hand the two healthy groups could be differentiated through the levels of ceruloplasmin (G1<G2) and alpha nitrogen (G1>G2). Thus it seems that the malaria-malnourishment state exists and the results could be framed either as a consequence of nutrient sink and/or the infection stress both motivated by the parasite.

Keywords: Malaria; Nutritional assessment; Malarial-malnourishment.


RESUMO

A avaliação antropométrica (pêso, altura, circunferência branquial, prega cutânea tricipital, prega cutânea subescapular, índice de Quetelet e circunferência muscular do braço) e bioquímica (proteínas e lipides) foi realizado em 120 indivíduos (93 masculinos e 27 do sexo feminino), de 17 a 72 anos de idade, moradores de área endêmica de malária (Humaitá -AM). De acordo com a história da doença (malária) eles foram divididos em 4 grupos: G1 - controle (n = 30), sem história de malária; G2 - controle (n = 40), com história de malária, mas sem manifestação de doença atual; G3 - doentes com Plasmodium vivax (n = 19) e G4 - doentes com Plasmodium faleiparum (n = 31). O diagnóstico de malária foi estabelecido por manifestações clínicas e confirmado laboratorialmente (gota espessa e esfregaço). No global as medidas antropométricas e bioquímicas discriminaram os grupos diferentemente. As medidas antropométricas do pêso, altura, reservas calóricas e estoque proteicos somáticos, apresentaram pouca sensibilidade, discriminado apenas os grupos extremos (Gl > G4). As medidas bioquímicas, no geral diferenciaram dois grandes grupos, os sadios e os doentes (G1+G2) e (G3+G4). Os doentes com Plasmodium falciparum (G4) foram os que se apresentaram em pior estado nutricional para a maioria das variáveis, sem entretanto, nenhuma variável individual que os discriminasse significativamente do G3. Estes dados permitem concluir que a malária resulta em desnutrição do hospedeiro, cuja gravidade está relacionada ao tipo e estágio da doença.


 

 

Full text available only in PDF format.

Texto completo disponível apenas em PDF.

 

 

ACKNOWLEDGEMENTS

We are grateful to Maria Rita C. Mathias for her technical assistance. Special and grateful thanks to Dr. Benjamin Caballero for his critical review of the manuscript.

 

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Correspondence to:
Dr. Paulo C. M. Pereira
Departamento de Medicina Tropical, Fac. Medicina/UNESP
18618-000 Botucatu, SP, Brasil

Recebido para publicação em 25/04/1994.
Aceito para publicação em 31/08/1994.

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