The prevalence and relationships of malaria, anemia, and malnutrition in a coastal area of El Salvador.

To study the relationships between malaria, anemia and malnutrition, 853 school-age children from a high malaria incidence area and an adjacent low incidence area were surveyed in September 1972. For the high incidence area the malaria slide positivity rate was 3.5%, spleen rate 7.6% and malaria (indirect fluorescent antibody) serology positivity 24.7%. Contrasted to this, no positive slides, only 3 palpable spleens and a 3.4% serology positivity rate were found for the low incidence area. Twenty-three percent of those studied were anemic, but the prevalence of anemia was the same in both the high and low incidence areas. However, a selected group of children with known history of recent or actual malaria was found to be more likely to have deficient hematocrit values than were children without such history. Hypochromia and microcytosis were prominent morphologic findings in children with anemia, suggesting a diagnosis of iron deficiency. Weights and heights for age were considerably below those of a U.S. reference population but similar to nationwide Salvadoran figures. In both the high and low incidence groups, 62% had arm circumference values below 90% of standard. The distribution of weight-to-height ratios was also similar for both groups. No difference in nutritional status between the two groups could be found.