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Malnutrition and acute respiratory tract infections in Filipino children
T E Tupasi1, N V Mangubat, M E Sunico
1Tropical Disease Foundation, Makati Medical Center, Manila, Philippines.
Insights
Malnutrition significantly increases the risk of acute respiratory infections (ARI) and acute lower respiratory infections (ALRI) in young Filipino children. Malnourished children face a higher mortality risk from severe ALRI, highlighting the need for nutritional interventions.
Area of Science:
- Pediatrics
- Public Health
- Nutrition Science
Background:
- Malnutrition is a significant global health issue, particularly in developing countries.
- Acute Respiratory Infections (ARI) are a leading cause of morbidity and mortality in children under five.
Purpose of the Study:
- To investigate the impact of malnutrition on the morbidity and mortality associated with acute respiratory tract infections (ARI) in Filipino children under five.
- To quantify the increased risk of ARI and acute lower respiratory tract infection (ALRI) in malnourished children.
Main Methods:
- A study was conducted on Filipino children under five years old.
- Malnutrition was assessed using weight-for-age Z-scores (less than -3 SD and less than -2 SD).
- Relative risks for ARI and ALRI morbidity and mortality were calculated and adjusted for confounding factors.
Main Results:
- Malnutrition was associated with a significant increase in ARI and ALRI morbidity.
- Children with severe ALRI and malnutrition had a two to three times higher mortality risk.
- These associations remained significant after adjusting for various clinical and demographic factors.
Conclusions:
- Nutritional status is a critical determinant of ARI and ALRI outcomes in young children.
- Interventions to improve nutrition are essential for reducing ARI-related morbidity and mortality.
- Addressing malnutrition is a key strategy in pediatric public health for infectious disease control.
Abstract:
The impact of malnutrition on morbidity and mortality associated with acute respiratory tract infection (ARI) was studied in Filipino children less than 5 years old. Malnutrition measured by weight-for-age Z-scores of less than -3 SD and less than -2 SD from the National Center for Health Statistics median reference population was associated with the following significant relative risks of morbidity: 1.24 (95% confidence interval [CI] = 1.14, 1.34) and 1.14 (95% CI = 1.08, 1.19), respectively, for ARI; and 1.9 (95% CI = 1.46, 2.39) and 1.2 (95% CI = 1.03, 1.47), respectively, for acute lower respiratory tract infection (ALRI). These risk ratios remained significant when adjusted for age, crowding, and parental smoking. Malnourished children with severe ALRI also had a mortality risk two to three times higher than that of healthy children. This risk remained significant even when adjusted for significant predictors of mortality, including clinical complications, concurrent measles, severe infections, and female gender; and for clinical factors, including extent of pneumonic infiltrates, dehydration, and hepatic enlargement. These findings underscore the importance of nutritional intervention in the control of morbidity and mortality among patients with ARI.