Nutritional status of children in a malaria meso endemic area: cross sectional study on prevalence, intensity, predictors, influence on malaria parasitaemia and anaemia severity

BACKGROUND: The contradictory results on the interaction between nutritional status and malaria warrants further investigation in various epidemiological settings, to assert the antagonistic or synergistic relationship. This study examines the prevalence, severity and predictors of malnutrition and its influence on malaria parasitaemia and anaemia severity in children in the Mount Cameroon area. METHODS: A cross-sectional study involving 454 children ≤ 14 years was carried out from February to May 2013 in Muea community. Anthropometric measures of malnutrition (z-scores < −2 standard deviations below mean) were obtained and spleen size assessed. The prevalence and density of malaria parasites were determined and haemoglobin concentration and white blood cell count obtained using an automated haematology analyzer. Univariate and multivariate analyses were used to evaluate influence of malnutrition on anaemia, malaria parasitaemia and predictors respectively. RESULTS: The overall prevalence of malnutrition was 22.8 %, with stunting being the most common form (17.1 %), followed by underweight (8.2 %) and wasting (5.5 %). Stunting was significantly higher (P < 0.01) in males (23.1 %) than in females (11.9 %). The prevalence of malnutrition was significantly highest (P = 0.03) in children ≤5 years old (29.5 %) than their counterparts. Severe stunting, wasting and underweight were prevalent in 4.9 %, 1.6 % and 1.8 % of the children respectively. Clinical malaria parasitaemia was significantly higher (P = 0.01) in children who were stunted (16.9 %) and underweight (21.6 %) than their normal counterparts (7.5 %; 8.2 % respectively). The model demonstrated sex (P = 0.006) and age group 1.1-3 years (P = 0.03) as significant predictors of malnutrition. In children who were malaria parasite negative, the prevalence of anaemia as well as severities were significantly higher (P = 0.04 and P = 0.001 respectively) in those malnourished. CONCLUSIONS: The presence of stunting in the community significantly augmented the prevalence and clinical presentation of Plasmodium infection. Malnutrition enhanced the severity of anaemia in malaria parasite negative children hence, their health and growth potential needs to be improved upon

Knowledge and perceptions towards malaria prevention among vulnerable groups in the Buea Health District, Cameroon

BACKGROUND: Malaria is a public health problem especially in vulnerable groups such as pregnant women and children under five years in Cameroon including the Buea Health District (BHD). Misconceptions concerning it exist. This study assessed the level of knowledge and perceptions towards malaria control among pregnant women and mothers/caretakers of under-fives in the BHD. METHODS: A community-based cross-sectional study was conducted in the BHD in August, 2011 in five health areas. A questionnaire was used to collect data on demographic variables, knowledge and perceptions towards malaria control from 443 respondents aged 15–73 years. RESULTS: Of the 443 respondents interviewed, 99% had heard about malaria. Awareness of malaria was similar in rural (98.04%) and urban (98.97%) areas. The health facility was the most popular source of information (74%). The radio, television, tracts/posters and the community relay agents (CRAs) all informed significantly higher proportions of respondents in the urban than rural communities (P <0.05). Overall, 92% of respondents had the right perception of malaria and 88% knew at least one correct sign/symptom of malaria. The most recognised sign of malaria was fever. When all aspects of malaria were considered, majority (88%) of respondents had good levels of knowledge on malaria. The level of good knowledge in respondents with ≥ secondary school education (91%) was significantly higher (P = 0.01) than in those with ≤ primary school level (83%). Overall, 99% had heard about insecticide treated nets (ITNs); 99% perceived ITNs as a good means to prevent malaria; most respondents (57%) used ITNs mainly for protection against mosquito bites while 48% used them for protection against malaria. CONCLUSION: Respondents with no formal education had a poor level of knowledge on malaria. Hence, new strategies for sensitization messages involving their active participation need to be developed

I belong, I feel safe, I feel brave: ASPIRE to create inclusive cultures for Black and Black (mixed) heritage students

Presentation at Institute of Student Employers EDI Conference (2022

Haematological changes and recovery associated with treated and untreated Plasmodium falciparum infection in children in the Mount Cameroon Region

Pre-hospital antimalarial treatment of febrile children remains a significant common practice among individuals in the Mount Cameroon region. To evaluate the effect of routinely administered monotherapy sulphadoxine pyrimethamine (SP), treatment using amodiaquine artesunate (AQAS) combination therapy and untreated malaria on haematological and parasitological parameters, 332 malaria positive subjects were assigned to three groups comprising 138 children treated with AQAS, 43 treated with SP and 151 untreated. The changes and recovery in red cell indices, white blood cell and differential and platelets counts were compared. The highest haematological recovery (39.1%) occurred in the AQAS treatment group. The majority (94%) of the untreated cases never achieved haematological recovery even though there was spontaneous clearance of parasites in some cases. Haematological insult was greatest in untreated children followed by those treated with SP, the 1.1 -3 year age group whether or not they received treatment and in those with high parasitaemia. Delayed parasite clearance observed in the untreated and SP treatment group may be responsible for the occurrence of haematological insult. Treatment type and parasitological cure was associated with haematological recovery. Prompt use of effective arthemisinin combination therapy reduced the burden of malaria, hence the greater clinical and haematological benefits observed in our study

Solar ultraviolet radiation and ozone depletion-driven climate change: Effects on terrestrial ecosystems

In this assessment we summarise advances in our knowledge of how UV-B radiation (280-315 nm), together with other climate change factors, influence terrestrial organisms and ecosystems. We identify key uncertainties and knowledge gaps that limit our ability to fully evaluate the interactive effects of ozone depletion and climate change on these systems. We also evaluate the biological consequences of the way in which stratospheric ozone depletion has contributed to climate change in the Southern Hemisphere. Since the last assessment, several new findings or insights have emerged or been strengthened. These include: (1) the increasing recognition that UV-B radiation has specific regulatory roles in plant growth and development that in turn can have beneficial consequences for plant productivity via effects on plant hardiness, enhanced plant resistance to herbivores and pathogens, and improved quality of agricultural products with subsequent implications for food security; (2) UV-B radiation together with UV-A (315-400 nm) and visible (400-700 nm) radiation are significant drivers of decomposition of plant litter in globally important arid and semi-arid ecosystems, such as grasslands and deserts. This occurs through the process of photodegradation, which has implications for nutrient cycling and carbon storage, although considerable uncertainty exists in quantifying its regional and global biogeochemical significance; (3) UV radiation can contribute to climate change via its stimulation of volatile organic compounds from plants, plant litter and soils, although the magnitude, rates and spatial patterns of these emissions remain highly uncertain at present. UV-induced release of carbon from plant litter and soils may also contribute to global warming; and (4) depletion of ozone in the Southern Hemisphere modifies climate directly via effects on seasonal weather patterns (precipitation and wind) and these in turn have been linked to changes in the growth of plants across the Southern Hemisphere. Such research has broadened our understanding of the linkages that exist between the effects of ozone depletion, UV-B radiation and climate change on terrestrial ecosystems

Photosynthetic characteristics of representative plant species of the mediterranean ecosystem

Key leaf properties tend to show predictable relationships with others at a global level, forming the so called “leaf economic spectrum”. Until now however, leaf traits related to protection and defense have not been fully incorporated into this spectrum. Moreover, the relationships between parameters of this spectrum have not been tested in plants thriving in the Mediterannean environment. Here, we tested the hypothesis that plant species of the Mediterannean flora show the same general relationships of the leaf economic spectrum and that parameters related to defence/protection (such as total phenolics and condensed tannins concentration, as well as the nitrogen to total phenolics concentration (N/TP) ratio) could be related to other key traits of leaf economic spectrum. Functional (photosynthetic capacity, transpiration and dark respiration activity, nitrogen content, total phenolics and condensed tannins concentration, carbon and nitrogen stable isotope ratios, Chlorophyll fluorescence parameters) and structural parameters (leaf thickness and density, leaf mass per area, transparent leaf area in heterobaric leaves) were measured in 30 representative plant species (representing three life forms) from two sites (Parnitha and Domnista) with different climatic conditions. Most of the relationships of the leaf economic spectrum were observed in the present study as well. Moreover, N/TP ratio was positively related with photosynthetic capacity expressed either per area (Amax,a) or per dry mass (Amax,m) and negatively correlated to leaf mass per area (LMA). These relationships were stronger than that between total leaf nitrogen concentration per dry mass (Nm) and Amax,m or Amax,m, indicating that photosynthetic capacity is determined not by nitrogen investments per se, but also by the defense/protection demands. Among life forms, herbs showed higher N/TP ratio than trees and shrubs. The results of the present study showed that N/TP ratio could be considered as an essential component of the leaf economic spectrum, indicating the balance between growth and defense/protection, in addition to its previously proposed roles as an indicator of leaf nutritional value and decomposition rates. The fact that there is a strong relationship between N/TP ratio and photosynthetic capacity, a physiological trait not directly related to herbivory or pathogen attack, indicates that this ratio possibly reflects the need of protection of primary metabolic processes against the side effects of stressful environments and that the levels of leaf phenolics in a certain species may reflect the different risk of photodamage.Το λεγόμενο «οικονομικό φάσμα των φύλλων» περιλαμβάνει συσχετίσεις μεταξύ κρίσιμων παραμέτρων των φύλλων σε παγκόσμια κλίμακα. Ωστόσο μέχρι σήμερα στο φάσμα αυτό δεν έχουν συμπεριληφθεί παράμετροι και χαρακτηριστικά που σχετίζονται με την άμυνα ή την προστασία των φύλλων. Εκτός αυτού, δεν είναι γνωστό εάν τις συσχετίσεις μεταξύ των παραμέτρων του οικονομικού φάσματος τις ακολουθούν και τα φυτικά είδη του μεσογειακού περιβάλλοντος. Στη διατριβή αυτή τέθηκε σε δοκιμασία η υπόθεση εργασίας σύμφωνα με την οποία τα μεσογειακά φυτά ακολουθούν τις βασικές συσχετίσεις του οικονομικού φάσματος και ότι ορισμένα αμυντικά/προστατευτικά χαρακτηριστικά των φύλλων (όπως π.χ. η συγκέντρωση των ολικών φαινολικών και των συμπυκνωμένων ταννινών, καθώς και ο λόγος του περιεχομένου αζώτου προς τη συγκέντρωση των ολικών φαινολικών, N/TP) ενδεχομένως σχετίζονται με κρίσιμες παραμέτρους του φάσματος αυτού. Προκειμένου να επαληθευτεί η υπόθεση εργασίας επιλέχτηκαν 30 αντιπροσωπευτικά φυτικά είδη της ελληνικής χλωρίδας από δύο θέσεις δειγματοληψίας στην Πάρνηθα και στη Δομνίστα. Στα είδη αυτά προσδιορίστηκαν κρίσιμες λειτουργικές (φωτοσυνθετική ταχύτητα, ταχύτητα διαπνοής και αναπνοής στο σκοτάδι, περιεχόμενο σε άζωτο, συγκέντρωση ολικών φαινολικών και συμπυκνωμένων ταννινών, οι λόγοι των σταθερών ισοτόπων του άνθρακα και του αζώτου, παράμετροι φθορισμού χλωροφύλλης) και δομικές παράμετροι (πάχος και πυκνότητα φύλλου, ειδική φυλλική μάζα, LMA, επιφάνεια διαφανών περιοχών του ελάσματος ετεροβαρών φύλλων). Ο υπολογισμός των παραμέτρων και οι συσχετίσεις μεταξύ αυτών επιβεβαίωσαν ότι σε γενικές γραμμές τα επιλεγμένα μεσογειακά είδη ακολουθούν το πρότυπο του οικονομικού φάσματος των φύλλων. Διαπιστώθηκε επίσης ότι ο λόγος N/TP συσχετίζεται θετικά με τη φωτοσυνθετική ικανότητα εκφρασμένη ανά μονάδα μάζας (Amax,m) ή ανά μονάδα επιφάνειας φύλλου (Amax,a), και αρνητικά με τη παράμετρο LMA. Οι συσχετίσεις αυτές διαπιστώθηκε ότι ήταν ισχυρότερες εκείνων μεταξύ του περιεχομένου σε άζωτο (Nm) και Amax,m ή Amax,m, γεγονός που υποδηλώνει ότι η φωτοσυνθετική ικανότητα δεν καθορίζεται μόνο από τις ανάγκες σε άζωτο (όπως είναι ήδη γνωστό και από το οικονομικό φάσμα των φύλλων), αλλά και από τις απαιτήσεις για άμυνα ή προστασία των φύλλων. Ο λόγος N/TP παρουσιάζει επίσης σημαντικές διαφορές μεταξύ των βιομορφών, η μέση τιμή του οποίου είναι υψηλότερη στα ποώδη φυτά έναντι αυτής των δένδρων ή των θάμνων. Τα αποτελέσματα της παρούσης μελέτης έδειξαν ότι ο λόγος N/TP θα πρέπει να θεωρείται πλέον ως μια ζωτικής σημασίας παράμετρος του οικονομικού φάσματος των φύλλων. Ο λόγος αυτός ενδεχομένως αντιπροσωπεύει την τρέχουσα ισορροπία μεταξύ ανάπτυξης και άμυνας/προστασίας των φύλλων, εκτός των ήδη μελετηθέντων ρόλων που του αποδίδονται ως δείκτη της διατροφικής αξίας των φύλλων και του ρυθμού αποδόμησης της βιομάζας. Η ισχυρή επίσης συσχέτιση μεταξύ του λόγου N/TP και της φωτοσυνθετικής ικανότητας, μιας δηλ. παραμέτρου που δεν σχετίζεται ευθέως με τις προσβολές παθογόνων ή τη φυτοφαγία, δείχνει ότι είναι πιθανό ο λόγος αυτός να αντιπροσωπεύει την ανάγκη προστασίας ζωτικών λειτουργιών έναντι αβιοτικών παραγόντων καταπόνησης και ότι τα επίπεδα φαινολικών ενός φύλλου ενδεχομένως αντικατοπτρίζουν το κίνδυνο φωτοοξειδωτικών ζημιών που μπορεί να προκληθούν από τους παράγοντες αυτούς