Interactions of diarrhea, pneumonia, and malnutrition in childhood

Abstract

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.

Trends in infectious disease incidence among children in Afghanistan at a time of public health services expansion

“…The high rate of malnutrition among children (25), a consequence of food insecurity (26), poor economy, extreme weather conditions, and ongoing conflict, may further contribute to mortality rates. The interaction between malnutrition and childhood infections (27), which results in a vicious cycle of more infections, makes it harder to tackle the burden of infections. While the fertility rate in Afghanistan is falling, the birth rate is still high compared with other countries in the region, at 39-48 per 1000 population (28).…”

Assessing Stunting and Predisposing Factors Among Children

“…Stunting becomes worse if feeding and nursing are inadequate. As early as 2 nd year of life, stunting becomes irreversible [6].…”

“…Authors have described that diarrhea and respiratory infection in children are potentially harmful to their normal linear growth [5,6]. Malnourished children could have growth pattern similar to that of nourished children; however, sustained diarrhea and other infections resulted into distorted growth pattern.…”

“…This event is highly pronounced in the 2 nd year of life. Its ill effects are maintained in later periods of childhood [5,6]. According to a report, poor quality of drinking water, poor sanitation, and hygiene is responsible for major proportion of malnutrition and diarrhea [7].…”

Vitamin D as an adjunct for acute community-acquired pneumonia among infants and children: systematic review and meta-analysis

“…[2] The consequences of pneumonia are even more severe on account of lower immunity among children with malnutrition. [3] Low-cost interventions for better management of pneumonia, particularly those which can boost the immune response, might hence contribute to decreased mortality rates from pneumonia in children.…”