Association between nutritional status, cell-mediated immune status and acute lower respiratory infections in Bangladeshi children
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Insights
Poor nutrition and weakened cell-mediated immunity increase acute lower respiratory infection (ALRI) risk in Bangladeshi children. Improving these factors can significantly reduce ALRI incidence and improve child health outcomes.
Area of Science:
- Pediatric infectious diseases
- Nutritional epidemiology
- Immunology
Background:
- Acute lower respiratory infections (ALRI) are a major cause of childhood mortality globally.
- Nutritional status and immune function are critical determinants of susceptibility to infections.
- Understanding these associations is vital for developing effective public health interventions.
Purpose of the Study:
- To examine the relationship between nutritional status, cell-mediated immune status, and the incidence of ALRI in young children.
- To identify key risk factors for ALRI in a rural Bangladeshi population.
Main Methods:
- A community-based longitudinal study was conducted in rural Bangladesh.
- 696 children aged 0-59 months were followed for one year, with regular morbidity data collection.
- Nutritional status (anthropometry) and cell-mediated immune status (skin tests) were assessed periodically.
Main Results:
- The incidence of ALRI was 23 episodes per 100 child-years.
- A high prevalence of malnutrition was observed: 73-78% below -2 z score weight-for-age, 15-30% below -2 z score weight-for-height, and 68-76% below -2 z score height-for-age.
- Malnutrition (weight-for-height and weight-for-age) was a significant predictor of ALRI (P < 0.05). Anergic children showed a trend towards higher ALRI risk (P=0.08).
Conclusions:
- Nutritional status is a significant determinant of ALRI risk in young children.
- Cell-mediated immune status may also play a role in ALRI susceptibility.
- Interventions aimed at improving nutritional status and immune function could reduce ALRI incidence in this population.
Objective:
To investigate the association between nutritional status, cell-mediated immune status and the incidence of acute lower respiratory infections (ALRI).
Design:
Community-based longitudinal study.
Setting:
Three villages in rural Bangladesh at Matlab.
Subject:
696 children aged 0-59 months were followed up for a year.
Methods:
Trained field workers visited all children every fourth day and collected morbidity data for the preceding three days by recall. To determine the type and severity of respiratory infections, the field workers physically examined each child reporting a cough. Anthropometric status was determined monthly and cell-mediated immune status by skin tests was assessed at the beginning of the study and thereafter every 3 months.
Results:
The incidence of ALRI was 23 episodes per 100 child-years. A total of 73-78% of the children were below -2 z score weight for age, 15-30% were below - 2 z score weight for height, and 68-76% were below -2 z score height for age. In logistic regression models, malnutrition as assessed by weight-for-height status [odds ratio (OR) 0.66, 95% confidence interval (CI) 0.45-0.96, P = 0.03] or weight-for-age status (OR 0.64, 95% CI 0.45-0.92, P = 0.02) was significant predictor of ALRI. Anergic children had a higher risk of ALRI which approached to be statistically significant (OR 1.81, 95% CI 0.92-3.55, P = 0.08).
Conclusions:
Improvement of nutritional and cell-mediated immune status in rural Bangladeshi children should reduce the incidence of ALRI.