CHAPTER ONE
INTRODUCTION
1.1     Background of Study
Malaria is a prevalent disease in tropical and subtropical areas of Africa. It is estimated that 1-3 million deaths occurs worldwide, mostly involving children under the age of 5years (Gouado et al., 2007). Malaria is a major public health challenge in Nigeria and it accounts for more cases and deaths than any other country in the world (Olasehinde et al., 2010). This disease is often linked to changes in climate, poverty, malnutrition and the double resistance of the malaria parasite to usual anti-malaria drugs and insecticides (Müller and Garenne, 1999). Infection by malaria can cause serious health problems and this often leads to death especially in children (Gouado et al., 2007). The disease is caused by malaria parasites (Plasmodium species) which are transmitted by the female anopheles mosquito (vector).There are today more than 25 named plasmodium species which infect primates. Four of the species are human parasites; P. falciparum, P. vivax, P. malaria and P. ovale (Trampuz et al., 2003). Epidemiological studies have demonstrated that P. falciparum is the most dangerous specie as it is responsible for most of the deaths caused by malaria (Greenwood et al., 2005). The malaria parasite is transmitted when an individual is bitten by infected female anopheles mosquito (Ochei and Kolhatkar, 2008). The main symptom of uncomplicated malaria in children is fever. Older children may present with headache, backache, chills, myalgia and fatigue (Olasehinde et al., 2010). Severe anaemia may exist alone or in combination with other complications particularly cerebral malaria and respiratory distress in which it portends worse prognosis (WHO, 2004). Consequences of severe malaria include coma and death if untreated, young children are especially vulnerable (Anemana et al., 2004). Laboratory diagnosis of malaria could be made by detection of parasite in blood] or by serological techniques (Ochei and Kolhatkar, 2008).
Micronutrients are trace elements that are required in small quantities to ensure normal metabolism, growth and physical well‐being. Some studies relating micronutrient status and malaria infection reported low plasma levels of certain micronutrient in acute malaria infection (Alonso, 2004). Iron and beta carotene which are reported to have modulatory effect on the pathogenesis of malaria, have been observed to be deficient in acute plasmodium falciparum infection (Lavender, 1993; Shankar and Prasad 1998;; Beard, 2001; Caulfield et al., 2004). The levels of micronutrients in children are of particular interest since adequate intake is of great importance for the well being, proper development, and functioning of the body starting from fetal life and throughout childhood. Micronutrients comprise of vitamins and minerals. Examples of vitamins are vitamin A, pro-vitamin A (Beta‐carotene), vitamin B1, vitamin B2, vitamin B6, vitamin B12, biotin, vitamin C, vitamin E, vitamin D, vitamin K ,folic acid, niacin and pantothenic acid while minerals include the trace elements such as iron, copper, iodine, manganese, selenium and zinc together with the macro elements calcium, magnesium, potassium and sodium (Asaolu and Igbaakin, 2009; Crook, 2012). Micronutrients have been implicated to play important roles in immunity and physiologic functions. For instance, Calcium is an important nutrient that plays a major role in bone and teeth formation, impulse transmission, catalytic activation among others (Nordin, 1997). Iron plays an important role in the production of heamoglobin, oxygenation of red blood cells and lymphocytes. It improves the function of enzymes in protein metabolism and enhances the function of calcium and copper (Asaolu and Igbaakin, 2009). Vitamin B12 is involved in the maturation of red blood cells. The folic acid coenzymes are specifically concerned with metabolic reactions involving the transfer and utilization of the one carbon moiety      (Crook, 2012). Micronutrients are found in small quantities within the body and they are obtained from a wide variety of foods.  No single food contains all of the micronutrients we need and, therefore, a balanced and varied diet is necessary for an adequate intake. Micronutrients deficiency is more frequent amongst children in developing countries (Gibson and Ferguson, 1998). These deficiencies may contribute to an increased risk of parasitic infection such as malaria (Mahomed, 2000).