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The impact of malnutrition on childhood infections

Judd L Walson1,2, James A Berkley1,3,4

  • 1The Childhood Acute Illness & Nutrition (CHAIN) Network, Nairobi, Kenya.

Current Opinion in Infectious Diseases
|March 24, 2018
PubMed

Insights

Malnutrition significantly increases childhood infection severity and mortality, particularly in developing regions. Understanding the complex interplay between nutrition, infection, and environment is crucial for effective interventions.

Area of Science:

  • Global child health
  • Infectious diseases
  • Nutritional science

Background:

  • Malnutrition is a major contributor to childhood mortality worldwide, especially in sub-Saharan Africa and South Asia.
  • Malnutrition exacerbates the incidence, severity, and fatality of common childhood infections.
  • The risks associated with malnutrition and infection extend beyond acute episodes, leading to significant post-discharge mortality.

Purpose of the Study:

  • To review the intricate mechanisms linking malnutrition, serious infections, and the child's environment.
  • To explore the evolving understanding of the 'vicious-cycle' between nutrition and infection.
  • To identify knowledge gaps and suggest future research directions.

Main Methods:

  • Literature review summarizing existing research on malnutrition-infection interactions.
  • Analysis of the 'vicious-cycle' concept, including dysbiosis, enteric dysfunction, and environmental factors.
  • Evaluation of past intervention trials and their outcomes.

Main Results:

  • Malnutrition increases infection incidence, severity, and case fatality.
  • The malnutrition-infection cycle involves dysbiosis, pathogen colonization, enteric dysfunction, and inflammation.
  • Previous interventions using antimicrobial prophylaxis or WASH have not shown public health benefits.

Conclusions:

  • Further research is needed to address key knowledge gaps in understanding immune competence and nutritional status during and after infections.
  • New tools and biomarkers are essential to characterize infection, intestinal permeability, and antimicrobial resistance.
  • A deeper understanding of these complex interactions is vital for developing effective strategies to reduce childhood mortality.
Abstract

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