Investigating the link between schistosomiasis and malnutrition in farming communities in rural Madagascar (nutriMad)

Aaron Remkes and Jean-Marc Kutz met during their scientific work at the Bernhard-Nocht Institute for Tropical Medicine. Both are students of medicine at the University of Hamburg and have already done research on different aspects of schistosomiasis in Madagascar. This is where the idea for their project nutriMad has started.

NutriMad’s objective is to examine the nutrition condition of rural communities in the district of Vatomandry on the east coast of Madagascar and to establish a possible connection between schistosomiasis and mal nutrition. Madagascar faces a grave food crisis which threatens to exacerbate due to the Russian-Ukrainian conflict. Half of the Madagascan population is undernourished and a large part of the small children under five years of age suffers from mal nutrition which leads to severe growth retardation and thus the underdevelopment of the immune systems.

Rural communities in Madagascar are severely burdened with Bilharzias. This Neglected Tropical Disease (NTD) infects people when they are in contact with contaminated waters, e.g. while working in rice fields. More than 230 million people are affected all over the world. Eight people out of ten in rural Madagascar need a treatment against Bilharzias. The exact data for rural areas like Vatomandry in Madagascar are currently not being recorded specifically. However, they are very important for an effective fight against the disease and adaptation of health measures. Bilharzias is the most common  reason for portal hypertension all over the world and the spectrum of complications ranges from ascites, esophagus varices, bladder carcinoma to severe gynecological manifestations like female genital Bilharzias.

The district Vatomandry is exemplary for a remote, rural region, where the largest part of the population works in the cultivation of rice and most probably is highly affected by Bilharzias. Malnutrition is omnipresent. Malnutrition and Bilharzias form a vicious circle, because the first increases the susceptibility for infection and chronic Bilharzias for its part impairs the work productivity and nutrient uptake. Therefore, it is our research interest to examine a possible connection between Bilharzias and malnutrition in Madagascar.
The project nutriMad as a part of the RESAMP Project will strengthen the German-Madagascan cooperation which celebrates its 60th anniversary this year.

The first stages of the research project are in full swing already. The project results and insights will contribute to the improvement of health of marginalized communities in Madagascar and above all influence the strategies of the public health sector in countries with similar epidemiologic patterns.

We intend to contribute in the effort to provide universal access to the highest possible health and nutrition standards for every person in the future. This will only work with the help of innovative research endeavors. The main goals for sustainable development of the United Nations schedule that all human beings, especially children, should be provided with appropriate and nutritious food as well as reducing the need to treat NTDs by 90 percent until 2030.

Research group

• Aaron Remkes
• Jean-Marc Kutz

Mentor

• Prof. Dr. Med. Jürgen May