Relationship of childhood protein-energy malnutrition and parasite infections in an urban African setting.

A clear understanding of protein-energy malnutrition (PEM), parasite infection and their interactions is essential in formulating health and development policies. We studied the prevalence of PEM indicators and the prevalence and/or intensity of infection in 558 Zairian children aged 4 months to 10 years. Multivariate analyses were used to estimate relationships between PEM indicators and parasitic infection. Stunting was found in 40.3% of children, wasting in 4.9% and kwashiorkor in 5.1%. The risk of stunting was significantly higher in children with Ascaris lumbricoides. The risk of wasting was higher in children with A. lumbricoides or Trichuris trichiura, whereas the risk of kwashiorkor was high with T. trichiura but very reduced in those with A. lumbricoides. Plasmodium infection was not related to nutritional indicators. These relationships highlight important interactions, both synergistic and antagonistic, between nutrition and parasites in central Africa.