Micronutrient Deficiencies and Plasmodium vivax Malaria among Children in the Brazilian Amazon

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dc.citation.issue3
dc.citation.volume11
dc.contributor.authorBenzecry, Silvana Gomes
dc.contributor.authorAlexandre, Marcia Almeida
dc.contributor.authorVitor-Silva, Sheila
dc.contributor.authorSalinas, Jorge Luis
dc.contributor.authorde Melo, Gisely Cardoso
dc.contributor.authorMarinho, Helyde Albuquerque
dc.contributor.authorPaes, Angela Tavares [UNIFESP]
dc.contributor.authorde Siqueira, Andre Machado
dc.contributor.authorMonteiro, Wuelton Marcelo
dc.contributor.authorGuimaraes Lacerda, Marcus Vinicius
dc.contributor.authorLeite, Heitor Pons [UNIFESP]
dc.coverageSan Francisco
dc.date.accessioned2020-08-21T16:59:53Z
dc.date.available2020-08-21T16:59:53Z
dc.date.issued2016
dc.description.abstractBackground There is a growing body of evidence linking micronutrient deficiencies and malaria incidence arising mostly from P. falciparum endemic areas. We assessed the impact of micronutrient deficiencies on malaria incidence and vice versa in the Brazilian state of Amazonas. Methodology/Principal Findings We evaluated children <10 years old living in rural communities in the state of Amazonas, Brazil, from May 2010 to May 2011. All children were assessed for sociodemographic, anthropometric and laboratory parameters, including vitamin A, beta-carotene, zinc and iron serum levels at the beginning of the study (May 2010) and one year later (May 2011). Children were followed in between using passive surveillance for detection of symptomatic malaria. Those living in the study area at the completion of the observation period were reassessed for micronutrient levels. Univariate Cox-proportional Hazards models were used to assess whether micronutrient deficiencies had an impact on time to first P. vivax malaria episode. We included 95 children median age 4.8 years (interquartile range [IQR]: 2.3-6.6), mostly males (60.0%) and with high maternal illiteracy (72.6%). Vitamin A deficiencies were found in 36% of children, beta-carotene deficiency in 63%, zinc deficiency in 61% and iron deficiency in 51%. Most children (80%) had at least one intestinal parasite. During follow-up, 16 cases of vivax malaria were diagnosed amongst 13 individuals. Micronutrient deficiencies were not associated with increased malaria incidence: vitamin A deficiency [Hazard ratio (HR): 1.51; P-value: 0.45]; beta-carotene [HR: 0.47; P-value: 0.19];zinc [HR: 1.41; P-value: 0.57] and iron [HR: 2.31; P-value: 0.16]). Upon reevaluation, children with al least one episode of malaria did not present significant changes in micronutrient levels. Conclusion Micronutrient serum levels were not associated with a higher malaria incidence nor the malaria episode influenced micronutrient levels. Future studies targeting larger populations to assess micronutrients levels in P. vivax endemic areas are warranted in order to validate these results.en
dc.description.affiliationUniv Estado Amazonas, Escola Super Ciencias Saude, Manaus, Amazonas, Brazil
dc.description.affiliationFundacao Med Trop Dr Heitor Vieira Dourado, Gerencia Maleria, Manaus, Amazonas, Brazil
dc.description.affiliationEmory Univ, Dept Med, Div Infect Dis, Atlanta, GA 30322 USA
dc.description.affiliationInst Nacl de Pesquisas da Amazonia, Lab Nutr, Manaus, Amazonas, Brazil
dc.description.affiliationUniv Fed Sao Paulo, Appl Stat, Sao Paulo, Brazil
dc.description.affiliationInst Nacl Infectol Evandro Chagas, Rio De Janeiro, Brazil
dc.description.affiliationFundacao Oswaldo Cruz, Inst Pesquisas Leonidas & Maria Deane, Manaus, Amazonas, Brazil
dc.description.affiliationUniv Fed Sao Paulo, Dept Pediat, Discipline Nutr & Metab, Sao Paulo, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo, Appl Stat, Sao Paulo, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo, Dept Pediat, Discipline Nutr & Metab, Sao Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
dc.description.sponsorshipFundacao de Amparo a Pesquisa do Estado do Amazonas (FAPEAM)
dc.description.sponsorshipFundacio Cellex
dc.description.sponsorshipIDFundacio Cellex: 483758/2009-4
dc.description.sponsorshipIDFundacio Cellex: G64334048/2007
dc.format.extent-
dc.identifierhttp://dx.doi.org/10.1371/journal.pone.0151019
dc.identifier.citationPlos One. San Francisco, v. 11, n. 3, p. -, 2016.
dc.identifier.doi10.1371/journal.pone.0151019
dc.identifier.fileWOS000371993000091.pdf
dc.identifier.issn1932-6203
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/57796
dc.identifier.wosWOS:000371993000091
dc.language.isoeng
dc.publisherPublic Library Science
dc.relation.ispartofPlos One
dc.rightsinfo:eu-repo/semantics/openAccess
dc.titleMicronutrient Deficiencies and Plasmodium vivax Malaria among Children in the Brazilian Amazonen
dc.typeinfo:eu-repo/semantics/article
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