Dietary Practices and Nutritional Status of Malaria-Infected and Non-Infected Children of Age 6-36 Months in Bondo District, Siaya County, Kenya
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Plasmodium falciparun, the deadliest malaria parasite, comprises 96% of malaria infections in Kenya, with Lake Victoria basin‟s prevalence at above 38%. The co-existence of malaria and anaemia in pre-school children is a public health problem in Bondo District. Malaria mortality increases with severity of under nutrition, with severely malnourished children being more likely to die from malaria than their well nourished counterparts. There are few studies comparing dietary practices and nutritional status of malaria-infected and non-infected children, aged 6-36 months, thus the purpose of the study. It was a comparative cross-sectional and analytical study. Simple random sampling was done to obtain a sample of 128 children (64 malaria-infected and 64 non-infected). Anthropometric measurements were taken, interviews were conducted with children‟s caregivers and biochemical tests done for HIV status, malaria and anaemia. Dietary intake information was collected using a 24-hour dietary recall and food frequency questionnaire. The researcher administered structured questionnaires and used them to collect demographic, socio-economic and environmental information. Nutritional status was assessed as wasting, underweight and stunting using the Z scores of WHO growth standards 2006. SPSS, Nutri-survey and ENA for SMART computer software programmes were used for data entry and analysis. Pearson‟s correlation coefficient was used to establish relationships between continuous data such as education, nutritional status, dietary intake and household income. Student t-test was used to compare normally distributed continuous data while the Chi-square tests were done to test relationships between malaria and nutritional status. Logistic regression analysis was done to identify factors associated with malaria and malnutrition. The study revealed that both malaria-infected and non-infected children‟s dietary practices were sub-optimal in line with WHO recommendations. For dietary diversity, 23.4% of malaria-infected and 29.7% of non-infected children were fed 4 or more food groups. For food frequency, 21.3% of children aged 6-8 months and 3.7% of 9-24 months were fed as recommended by WHO. Malaria-infected and non-infected children were malnourished in terms of wasting, underweight, stunting and anaemia. Almost thirty percent (29.7%) malaria-infected and 14.0% of non-infected were wasted while 28.1% malaria-infected and 12.5% non-infected were underweight. Stunting was 28.1% among malaria-infected and 23.4% among the non-infected. Anaemia was common, as 92.2% of children in both groups were deficient with haemoglobin below 10.9 g/dl (WHO). Socio-economic factors related to malaria and nutritional status were: level of education of caregivers, household income and types of housing (p<0.05). Use of mosquito nets was common. However, most were not insecticide treated. The study, therefore, concluded that there were no significant differences in dietary practices of malaria-infected and non-infected children. Nonetheless, there were significant differences in their nutritional status with the non-infected children being better nourished. It is recommended that the Ministry of Health and stakeholders concerned with child health initiate nutrition and health education, on the relationships between malaria, anaemia and nutritional status, in the District. Good health of the children would enable the community to participate more in income generating activities thus reducing poverty levels. This would improve their livelihoods as malaria is a contributing factor to poverty and poor nutritional status.