Burden of Infection on Growth Failure

Abstract

The high prevalence of infections among children living in poor areas of developing countries impairs linear growth in these populations. Acute, invasive infections, which provoke a systemic response (e.g., dysentery and pneumonia), and chronic infections, which affect the host over a sustained period (e.g., gut helminth infections), have a substantial effect on linear growth. Such infections can diminish linear growth by affecting nutritional status. This occurs because infections may decrease food intake, impair nutrient absorption, cause direct nutrient losses, increase metabolic requirements or catabolic losses of nutrients and, possibly, impair transport of nutrients to target tissues. In addition, induction of the acute phase response and production of proinflammatory cytokines may directly affect the process of bone remodeling that is required for long bone growth. Infection of cells directly involved in bone remodeling (osteoclasts or osteoblasts) by specific viruses may also directly affect linear growth. Many interventions are possible to diminish the effect of infection on growth. Prevention of disease through sanitation, vector control, promotion of breast-feeding and vaccination is crucial. Appropriate treatment of infections (e.g., antibiotics for pneumonia) as well as supportive nutritional therapy (again including breast-feeding) during and after recovery, is also important. Targeted therapeutic interventions to decrease the prevalence of gut helminth infections may also be appropriate in areas in which such infections are widespread. Such interventions are of public health benefit not only because they reduce the incidence or severity of infections, but also because they decrease the long-term detrimental effect of malnutrition on populations.

A developmental view of the undernourished child: background and purpose of the study in Pangalengan, Indonesia

“…Besides limiting daily dietary intake (Martorell et al, 1980), morbidity in general and gastro-intestinal infections in particular are powerful contributory factors to the causation of undernutrition and growth failure (Stephenson, 1999;Mata, 1992). However, except for a few studies (Pollitt, 1983;Neumann et al, 1992;Grantham-McGregor et al, 1999), there is very scarce information on the effects of morbidity on motor development, physical activity and emotional regulation.…”

The effect of nutrition and severity of iron deficiency anaemia on growth in children from two months to two years of age

“…Low intakes of energy, protein, and micronutrients provided by the incorrect feeding practice can all contribute to impaired child growth. Moreover, inadequate nutrition may also deteriorate growth indirectly by its adverse effects on the immunity leading to more frequent and long lasting infections which diminish growth rate (18,19). However, this study does not provide an assessment of incidence of infectious disease among investigated children with IDA.…”

Relationships between undernutrition prevalence among children and adult women at national and subnational level

“…Where problems of undernutrition in children are serious, but where adults appear to be, on average, in a relatively better nutritional condition, factors other than household level food shortages are likely to be responsible for the occurrence of undernutrition in children. Among these factors are, for example, frequent occurrence of infectious diseases, and associated poor water and sanitation conditions, poor quality of diets with deficiencies in micronutrients (vitamins, minerals), and insufficient opportunities for mothers or other caretakers to provide their children with adequate care (Stephensen, 1999).…”