Diet and cerebral malaria: the effect of famine and refeeding

In an outbreak of Plasmodium falciparum malaria following refeeding after famine cerebral malaria was restricted to children eating grain. Nomad children consuming a predominantly milk diet were free of this complication despite an equivalent incidence of uncomplicated malaria. Freedom of nomads from cerebral complications may be due to inhibition by the milk diet of rapid division of the parasite combined with delayed recovery after famine ofT cellfunction. Am. J. C/in. Nutr. 31: 57-61, 1978. The precise mechanism of cerebral ma- lana following infection with Plasmodium falciparum is unknown but Edington pointed out that well-nourished children in Nigeria seemed more susceptible to this complication than the malnourished (1). During the Sahel drought and famine of 1974 and following on an acute outbreak of falciparum malaria , we were able to conduct a prospective study of the impact of starva- tion and refeeding on the occurrence and course of that disease and its cerebral com- plications in Fulani nomad and Kanouri nonnomad children . Our interest was aroused by the apparent freedom of no- madic Fulani children from cerebral ma- laria. The study was conducted at Diffa, Niger 140 kilometers west of Lake Chad and just north of the Nigerian border where the nomad's area of transhumance closely approximated the territory occupied by the Kanouri nonnomads.