Review

Malaria and vitamin A deficiency in African children: a vicious circle?

Miguel A SanJoaquin^1* and Malcolm E Molyneux²

• * Corresponding author: Miguel A SanJoaquin msanjoaquin@mlw.medcol.mw

Author Affiliations

¹ Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, Po Box 30096, Chichiri, Blantyre 3, Malawi

² Liverpool School of Tropical Medicine, Liverpool, UK

For all author emails, please log on.

Malaria Journal 2009, 8:134 doi:10.1186/1475-2875-8-134

Published: 17 June 2009

Abstract

Vitamin A deficiency and malaria are both highly prevalent health problems in Africa. Vitamin A deficiency affects over 30 million children, most of whom are in the age-group (under five years) most affected by malaria. Vitamin A deficiency increases all-cause mortality in this part of the population, and malaria is an important cause of death in children at this age. A low serum retinol concentration (a marker of vitamin A deficiency) is commonly found in children suffering from malaria, but it is not certain whether this represents pre-existing vitamin A deficiency, a contribution of malaria to vitamin A deficiency, or merely an acute effect of malaria on retinol metabolism or binding. In this paper, available evidence in support of a causal relationship in each direction between vitamin A deficiency and malaria is reviewed. If such a relationship exists, and especially if this is bidirectional, interventions against either disease may convey an amplified benefit for health.