ArticleNarra J2024
Impact of early-life malaria exposure on childhood stunting: A case-control study in high endemic malaria area, Papua, Indonesia.
Article in Narra J, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Papua faces public health challenges as a region with high malaria endemicity and a very high prevalence of stunting. Infectious diseases are one of the risk factors for stunting. The aim of this study was to investigate the effect of early-life malaria exposure on stunting among children in Papua. The study was conducted in 14 public health centers (PHCs) in Papua in 2023. Six hundred eighty-one children (227 stunted and 454 non-stunted) were selected using simple random sampling. The study data were gathered from medical records, structured parent interviews, and direct anthropometric measurements of the children. Chi-square tests were performed to determine unadjusted OR, while adjusted OR was calculated using multivariate analysis. The height-for-age z-score was calculated using WHO Anthro version 3.2.2. The results showed that 45.1% of mothers who had malaria during pregnancy had stunted children. The average z-score height-for-age of children from mothers who experienced malaria during pregnancy vs those who did not was -1.69 ± 1.23 vs -1.41 ± 1.55. Among the 84 children who had malaria under one year old, 45.2% experienced stunting. The average z-score height-for-age of children who had malaria under one year old vs those who did not was -1.83 ± 1.24 vs -1.38 ± 1.6. In the unadjusted analysis, malaria during pregnancy (OR 1.74; 95%CI: 1.06-2.87), malaria in children under one year old (OR 1.78; 95%CI: 1.12-2.83), low birth weight status (OR 1.82; 95%CI: 1.08-3.05), family income (OR 1.75; 95%CI: 1.09-2.81), and mother's ethnicity (OR 1.45; 95%CI: 1.05-2.01) were associated with stunting incidence in children. In the multivariate analysis, mother's ethnicity (aOR 1.41; 95%CI: 1.00-1.97) and low birth weight status (aOR 1.72; 95%CI: 1.00-2.94) were the only risk factor for stunting. This study suggests a potential association between early-life malaria exposure and stunting in children. In malaria-endemic areas, health interventions targeting malaria prevention during pregnancy and early childhood are necessary to reduce the risk of stunting.
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