The effect of malnutrition on the risk of diarrheal and respiratory mortality in children < 2 y of age in Cebu, Philippines.
The effects of nutritional status on diarrheal and acute lower respiratory infection (ALRI) mortality in children < 2 y of age were examined by using data from a 1988-1991 longitudinal study of 9942 children in Metro Cebu, Philippines. Cox regression methods were used to study the strengths of the associations, possible interactions with birth weight and breast-feeding status, and the effect of additional confounding factors. Nutritional status as measured by weight-for-age was a significant risk factor for both ALRI and diarrheal mortality in the first 2 y of life. Poor nutritional status resulted in a 1.6-fold increased risk of diarrheal mortality for each one-unit decrease in weight-for-age Z score. For ALRI mortality, a one-unit decrease in weight-for-age Z score resulted in a 1.7-fold increase in risk, and for mortality associated with ALRI and diarrhea combined, the relative risk was 2.0. This study provides further evidence that malnutrition is a major determinant of mortality in very young children and it is one of the first longitudinal studies to estimate the magnitude of the effect on cause-specific mortality associated with nutritional status.
Yoon
P W
PW
Department of International Health, Johns Hopkins School of Hygiene and Public Health, Baltimore 21205, USA.
Black
R E
RE
Moulton
L H
LH
Becker
S
S
D000208:Acute Disease; D001724:Birth Weight / Q000502:physiology; D001835:Body Weight / Q000502:physiology; D001942:Breast Feeding; D003968:Diarrhea, Infantile / Q000453:epidemiology / Q000401:mortality* / Q000503:physiopathology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008171:Lung Diseases / Q000453:epidemiology / Q000401:mortality* / Q000503:physiopathology; D009748:Nutrition Disorders / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology*; D009752:Nutritional Status; D010679:Philippines / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D012959:Socioeconomic Factors; D016019:Survival Analysis; D013997:Time Factors