Malaria and malnutrition are causes of high morbidity and mortality in developing
countries especially in sub-Saharan Africa and Asia. Malnourished children are at
higher risk of developing malaria, a problem compounded by the fact that
malnutrition affects the metabolism of different antimalarials including chloroquine
and quinine. Emerging resistance to chloroquine, which was the drug of choice, has
led to the widespread use of artemisinin combination therapy in the population
including children. To date, no studies have been undertaken on the
pharmacokinetics of artemisinin compounds in malnourished children. This thesis
aims to fill this evidence gap by studying patients with uncomplicated malaria of
different nutritional status in The Gambia.
Analysis of the nutritional status of 97 children in The Gambia with uncomplicated
malaria showed that 30% were both underweight and wasting, while 28% were
categorised into stunting. This was much higher than the national average which has
been estimated to be 17.4%, 9.5% and 23% for underweight, wasting and stunting,
respectively, demonstrating a potential relationship between malaria and Protein
energy malnutrition.