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Interactions of diarrhea, pneumonia, and malnutrition in childhood: recent evidence from developing countries
Elizabeth P Schlaudecker1, Mark C Steinhoff, Sean R Moore
1Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio 45229, USA.
Insights
Undernutrition, diarrhea, and pneumonia form a harmful cycle in children in low-income countries. New research clarifies these interactions and suggests interventions like breastfeeding and vaccines to improve child health.
Area of Science:
- Child Health
- Infectious Diseases
- Nutritional Science
Background:
- Diarrhea and pneumonia negatively impact child growth.
- Malnutrition is a significant risk factor for these infections.
- These conditions create a detrimental cycle in children.
Purpose of the Study:
- To review recent advancements in understanding the interplay between diarrhea, pneumonia, and undernutrition.
- To highlight progress in low- and middle-income countries.
Main Methods:
- Literature review of recent studies.
- Synthesis of findings on risk factors, prevention, and genetic influences.
Main Results:
- Diarrhea and pneumonia impair growth; malnutrition exacerbates these conditions.
- Breastfeeding and micronutrients aid prevention and control.
- Vaccine efficacy and genetic predispositions are explored.
- Influenza and pneumococcal immunizations show growth benefits.
Conclusions:
- Significant progress has been made in understanding the malnutrition-diarrhea-pneumonia cycle.
- Translating research into accessible public health interventions remains a key challenge.
Purpose Of Review:
This review highlights recent progress toward understanding complex interactions between diarrhea, pneumonia, and undernutrition among children in low-income and middle-income countries.
Recent Findings:
New studies parallel earlier reports that diarrhea and pneumonia impair children's growth and that underlying malnutrition is a major risk factor for these conditions. Episodes of diarrhea may predispose to pneumonia in undernourished children. Additional studies support breastfeeding and micronutrient supplementation for the prevention and control of diarrhea and pneumonia. Malnutrition may partially account for the reduced efficacy of oral rotavirus vaccines in low-income countries. Immunization of pregnant women against influenza also appears to reduce intrauterine growth retardation. Immunization of infants against Streptococcus pneumoniae may improve their growth. New genetic studies indicate that polymorphisms in apolipoprotein E or the leptin receptor modulate children's risk for diarrhea and Entamoeba histolytica infection, respectively, thereby linking two genes important for lipid metabolism to enteric infections.
Summary:
Significant advances have been made in understanding the vicious cycle of malnutrition, diarrhea, and pneumonia in developing countries. Future challenges will be to translate this progress into effective and widely accessible public health measures.
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