Discussion
malaria
MALARIA
The present study evaluated the impact of three different dietary interventions on the occurrence of asymptomatic malaria among 6–18 months old Malawian children. This study reported the overall prevalence of asymptomatic malaria among young children as 14.1% in rural Malawi. There was no statistically significant association found between LNS provision and the prevalence of asymptomatic malaria. In contrary to the original hypotheses, the provision of CSB was associated with a higher malaria prevalence.Randomized study design, large sample size, investigators blinded to the samples’ status, and use of real-time PCR (sensitive and accurate method for detecting asymptomatic malaria cases) reduced the probability of random error or bias in the current study. Differences in laboratory methods, excluded participants or those with missing data (due to either loss of cases, visits, or blood specimens) could have affected internal validity. Nevertheless, standard procedures for laboratory sample collection, storage, and methods were used across the study. Furthermore, included and excluded participants had similar baseline characteristics. Therefore, the findings of this study are valid and representative and not supportive of a hypothesis that the tested dietary supplements would reduce the prevalence of asymptomatic malaria prevalence in this target population of 6–18-month-old children in Malawi.There are a limited number of clinical trials that have evaluated the potential effects of micronutrient supplements on children living in malaria-endemic areas which lead to different outcomes either protective, adverse, or no effects [In this study, CSB supplementation was associated with a higher malaria prevalence among 6–18-month-old children. Among the three intervention used in this study, CSB has a lower nutrient density and it was associated with relatively poor linear growth outcomes in a prior study [